Thank you for choosing us for your healthcare needs. Our goal is to provide and maintain a good physician-patient relationship. The following is our Financial Policy, which we ask you to review and sign before your first visit.
Your co-payment, deductible, co-insurance, or pending balance is due at the time of service. We accept cash, checks, American Express, Discover, MasterCard, and Visa. We can also store your preferred method of payment in your account demographics.
Our providers participate in various insurance and managed care plans. We are happy to bill your health insurance carrier as a courtesy to you. We suggest all patients review their health coverage with their carrier before receiving services or treatment. The patient is responsible for notifying us of any changes regarding the insurance policy. Your insurance policy is a contract between you and your insurance company, and the staff will not know all the terms of your insurance policy. Please be aware that some, and perhaps all, of the services provided may be non-covered and not considered reasonable and necessary under the Medicare program and other medical insurance. The patient/financial guardian will be responsible for any remaining balances.
Patients without health insurance are expected to pay at the time of service. As a courtesy, we offer a 20% discount on most services rendered. If you are unable to pay the full balance at the time of service, the remaining balance is expected upon receipt of your first statement.
Priority Medical Group has a plan for outstanding balances owed under certain circumstances of financial hardship. We are willing to discuss your situation and try to work out a plan that will meet both your needs and the needs of the medical group. Please consult with one of our billing staff for further information.
We will bill your employer’s workers’ compensation insurance carrier and follow all other procedures as required by the state’s worker’s compensation laws. As the patient, it is your responsibility to notify us prior to the visit that it is a work-related case and to provide us with the appropriate worker’s compensation policy information.
Due to state laws surrounding auto insurance payments and payment delays, we regret to inform you that we may not be able to bill third-party administrators in liability cases. In addition, we cannot suspend our regular billing and collection process when services have been rendered. Your health insurance carrier or financial guarantor will be billed for the services.
There will be a $60.00 fee on all returned EFT/CCC. If an EFT/CCC is returned for insufficient funds, we reserve the right to contact your bank to verify funds for any future EFT/CCC presented for payment on your account.
Any outside forms incur an extra $35 charge that must be paid before the form can be filled out. These forms will be available for pickup 48 hours after presentation to the provider.
No-Show Appointments: Unless canceled 24 hours prior to the scheduled appointment, your appointment will be considered a no-show. Our policy allows us to charge a $75.00 fee for these missed appointments. Please help us serve you better by keeping your scheduled appointments. You will not be rescheduled for future appointments until your account balance is paid in full.
Thank you for understanding our financial policy. Please let us know if you have any questions or concerns.
I have read and understand this financial policy. I agree to follow all financial policies stated above: