Our office is implementing
Program. The reason for the new policy is the change in insurance plans
for most patients. Plans now have higher co-payments, coinsurance and
deductibles. This leads to greater patient responsibility for payment
of services. We will require all patients to leave a credit card number
on file with our office. or pay in full the time of the visit. The card
information is encrypted and stored with our partner, Authorize.net, one
of the largest credit card processors in the USA.
The card will only be used
for balances after your insurance company has processed your claim and
we receive the explanation of benefits.
We understand this is a big
departure from what is currently done in medical offices. However, as
the landscape of the insurance industry changes, this policy will become
standard in all offices. In other businesses such as hotels, car rental
companies and health club memberships, giving ones credit card is very
Why the change?
There are several reasons. First, we need to ensure that we have a guarantee
of payment on file in our office. Health insurance is changing and plans
now have higher co-payments, coinsurance and high deductibles. This leads
to greater patient responsibility for payment of services. Second, we
need to be sure that patient balances are paid in a timely manner, so
we can continue to provide high quality medical care. Thirdly, statements
are wasteful of paper, stamps, and envelopes. This program allows us to
keep our costs down.
But I always pay my bills,
We have to be fair and apply the policy to all patients. We have wonderful
patients and we know that most of you pay your balances. Unfortunately,
this is not the case every time.
How will I know how much you are going to charge me?
You will receive a letter in the mail from your Insurance carrier that
explains how much of your office visit they pay and how much you pay.
This is called an Explanation of Benefits, or EOB. This letter tells you
exactly, according to your health insurance coverage, how much of your
health care bill is your responsibility and how much is the responsibility
of your insurance to pay.
We receive the same letter that you do. It arrives about 7 to 30 days
after your appointment. We look at each Explanation of Benefits (EOB)
carefully, and determine what your insurance has determined as patient
responsibility. This is the same way we normally determine how much to
send you a bill for in the mail.
But wait, I'm nervous
about leaving you my credit card information.
We do not store your sensitive credit card information in our office.
After the initial transaction, we never see the credit card number. We
use a secure vendor that is completely compliant as required by law. Alternatively,
you may leave a deposit in the form of cash or check.
What if I need to dispute my bill?
First, contact your insurance carrier for additional information on how
they processed the claim. We will always work with you to understand if
there has been a mistake, and we will refund you if we have made a billing
error. We will only charge the amount that we are instructed to by your
insurance carrier, in the letter , or Explanation of Benefits they send
to us, in the same way that we normally determine how much to send you
a bill for in the mail.
When do I have to pay
Any time you receive medical care, you will be expected to pay in full
for your services until your deductible is met. If you have a very large
deductible, called a high-deductible insurance plan, you may have to pay
out of pocket for most of your primary care services.
How will I know when my
deductible has been met?
You can call your insurance
company at any time to check on how much of your deductible has been met
and some insurance companies have this information available online. Every
time you receive medical services, you will receive notification from
your insurance company with how much they paid or did not pay if the amount
went to your deductible.
Will you send me a bill
to let me know what I owe?
You will receive a letter
in the mail from your Insurance carrier that explains how much of your
office visit they pay and how much you pay. This is called an Explanation
of Benefits, or EOB. With your credit card on file, there is no need to
get a separate statement from us. This greatly reduces your paperwork!
What is a Deductible and
How Does It Affect Me?
An annual deductible is the
dollar amount you must pay out of pocket during the year for medical expenses
before your insurance coverage begins to pay.
For example, if the policy
has a $500 deductible, you must pay the first $500 of medical expenses
before the insurance company begins to pay for any services.
This works just like the
deductible for your car insurance or homeowner's insurance policy does.
When does a deductible
Your deductible begins at
the start of your plan year. Most plan years begin either January 1 or
July 1, but plans can start on any date.
What if I have more questions?
Our billing staff is happy
to speak with you about your account at any time. Please contact our billing
service, Physician Business Solutions, 585-385-9045 or firstname.lastname@example.org.