What Forms of Payment Do We Accept?

We accept most major insurance plans. We have also been designated as a select Tier 1 provider for United Health Care, Aetna, Blue Cross/Blue Shield, and Humana. This means that we have agreed to charge less money for our services when working with these insurance companies.

For the convenience of our patients, we also accept credit cards, checks and cash.

How Does Our Billing Process Work?

Every symptom, medication, diagnosis and service related to your care is assigned a code. Our billing department uses these codes to process claims and request payment from your insurance company on your behalf.

The types of primary services include office visits, procedures and durable medical equipment:

Office visits:

• New Patient Office Charges: a one-time fee unless the patient’s last visit was 3 years ago (a standard practice in healthcare)
• Follow-up Visits

Procedures:

• These are assigned codes for various treatments your podiatrist performs ranging from simple treatments like trimming calluses or removing ingrown toenails, to major procedures such as surgery.

Durable Medical Equipment (DME):

• This is medically necessary equipment that your podiatrist prescribes for home use, to aid in your recovery or to improve your quality of life, such as crutches, braces, special bandages, etc.

What Happens After Your Claim is Submitted to Your Insurance Provider?

After your office visit, our billing representatives will process your claim. Your insurance company will respond in one of the following ways:

• Accept and pay the claim
• Deny the claim as an uncovered service or for some other reason
• Ask for additional information

Sometimes this process can get delayed and patients may feel frustrated or confused. Please know that we are working hard to get the issue resolved, and are always here to answer questions or to provide status updates.

Balance Due Statements

You will receive a statement after your claim has been fully processed which will reflect any balance that may be due. Scheduled correspondence from our billing department will be as follows:

• Statement issued: 00 to 30 days past due
• Statement issued: 31 to 60 days past due
• Statement issued: 61 to 90 days past due
• Demand letter sent: 91 to 120 days past due
• Balance sent to 3rd Party Collection Agency: 1121+ days past due

If your balance due is 121 days past due or more, you will be contacted by our 3rd party collection agency which, unless otherwise prohibited by law, is authorized to contact you via:

• Telephone calls (including mobile phone numbers and any other number you provided us with as part of your patient registration).
• Text messages or emails
• Artificial voice messages, pre-recorded messages, or automatic daily services. Please note that message, phone, and/or data charges may apply.

Who Determines Charges?

Insurance carriers have negotiated contractual rates that dictate health care payments for services and goods we provide: 54% is based on the physician’s work, 41% is based on practice expense, and 5% is malpractice expense. Rates will vary depending on which plan you have.

Medicare and Medicaid have their own non-negotiable, set fees which are determined by state and federal governments.

Can bills be negotiated?

Any amount you may owe as reflected on your statement depends on benefits determined by your insurance carrier and plan. We do not reduce any balance due. It would be illegal for us to waive any co-pay or reduce the deductible you need to pay as determined by your insurance carrier. Reducing payments for Medicare or Medicaid patients violates Anti-Kick Back statutes and the Stark Law, as well as the ERISA act if you are under your employer’s plan.

Do you offer payment plans?

We want to make sure that every patient receives the care they need. In that spirit, we may offer payment plans to certain patients. These payment plans require a credit card to be placed on file, which will be charged on the due date if the payment has not already been made through other means.