firmly believes that a good physician/patient relationship
is based upon understanding and good communication. We are
committed to providing you with the best possible medical
care. The following is our financial policy:
- All co-payments, coinsurance and
deductibles are due and payable at the time of service,
regardless of who brings the patient in for the appointment.
Sitters, grandparents, divorced parents, etc., must be prepared
to pay at the time of service. The Clinic for Neurology,
P.A. accepts cash, checks, debit cards, Discover, MasterCard,
and VISA. We reserve the right to assess a service charge
to accounts that require multiple billing for co-payments.
- There is a $35 service charge for
returned checks. We reserve the right to report returned
checks to the Madison County District Attorney's Worthless
Check Unit. After receiving two returned checks, The Clinic
for Neurology, P.A. will only accept cash or credit card
as payment for future balances.
- If you need financial assistance
or have questions, please contact our Billing Department.
- If you fail to meet financial obligations
agreed upon in this financial policy or other payment arrangements
made with The Clinic for Neurology, P.A., your outstanding
balance will be sent to a collection agency and you will
be required to pay the entire amount plus any collection
agency fees before being scheduled for any further appointments.
- Overpayments will be refunded after
all charges have been processed and paid by your insurance
company. A refund check will be written and mailed within
30 days of your written or verbal refund request.
- Our office participates with a variety
of insurance plans. It is your responsibility to:
a.) Bring your insurance card to each visit and notify us
of any changes.
b.) Know your co-payment amount and be prepared to pay this
amount at each visit.
c.) Know your insurance company benefits (physical exam
coverage, diagnostic testing co-payment amounts and pre-certification
d.) If you are enrolled in a Managed Care Insurance Plan
(HMO) it is YOUR responsibility to obtain or ensure a referral
is supplied to our office from your PCP or primary care
physician prior to the time of your appointment. Without
this referral, you cannot be seen by our physicians.
- If you insurance coverage through
a plan that we do not participate with, our office is happy
to file the claim for you upon request as a courtesy. However,
you are responsible for payment in full at the time of service
and you will be reimbursed upon payment being received from
your insurance company in the event that the payment is
not made directly to you.
- We file secondary insurance claims
as a courtesy. If your secondary insurance has not paid
within 60 days of our first filing, you automatically become
responsible for the balance of unpaid charges.
As a new patient, you will be given
a copy of this Financial Policy and you will be asked to read
and understand "The Clinic for Neurology, P.A. Financial
Policy" and agree to assign insurance benefits to The
Clinic for Neurology, P.A. whenever applicable. In the event
of nonpayment of default, you will be responsible for all
costs of collection, including, but not limited to, collection
agency fees, court costs and reasonable attorney fees. The
Clinic for Neurology, P.A. reserves the right to change or
amend this financial policy at any time and at its discretion.