Advanced Foot & Ankle Care, LLC. - Financial Policy
Advanced Foot & Ankle Care, LLC. - Where we take it one step at a time!
 
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FINANCIAL POLICY
 
Welcome To Our Office
 
Thank you for choosing us as your podiatric physicians. We are committed to your treatment being successful, as you, the patient, are our first and foremost concern. We focus on providing the best available care and want our billing service to be as easy as possible. In an effort to do this, we have outsourced our billing to CMOCC. The billing process can sometimes be complex, so we would like to prepare you for what to expect.
 
BILLING PROCESS: 
 
Upon complete registration, your insurance will be verified immediately. This will allow CMOCC time to contact you via email, fax, or phone in regards to your co-pay, deductibles, coinsurance, unpaid deductibles, referral status, and/or self-pay status. You are required to pay any balance due at the time of service. 
 
A claim will be sent to your insurance company within 24 hours of being seen. After receiving the claim, the insurance company may contact you for more information. Your quick response to their questions will assist your insurance company in processing your claim in a timely manner.  It usually takes 14 – 30 days for the insurance company to pay your claim. After we receive your insurance eob {explanation of benefits}, we will provide you with a statement showing the insurance payment/denial and any amount you may owe. Please keep in mind that your policy is a contract between you and your insurance company.  
 
In the event a patient does not have an insurance card on file, or does not have required referrals or pre-authorizations on file, there will be a $150 fee to be paid prior to seeing the doctor. If tests or procedures are performed during the visit, additional charges may be due at the end of the visit. Once we receive appropriate insurance documentation, your insurance company will be billed and you will be promptly refunded after the insurance company remits payment.
 
You cannot assume that your referral has been approved unless you have received written confirmation from your insurance company. If you are not sure your referral has been approved, please contact your insurance company prior to your appointment. If we do not have a paper copy of the referral in the office you may be financially responsible for the appointment, unless other arrangements are made with CMOCC at the time of service.
 
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Advanced Foot & Ankle Care along with CMOCC has implemented a Financial Policy. The following is a statement of our FINANCIAL POLICY which we request you read and sign prior to any treatment.
 
INSURANCE: If your doctor is a participating provider with your insurance plan, we will submit the claim to your insurance company. To do this we must have complete and accurate insurance information and a copy of your identification card or claim form. Your insurance policy is a contract between you and your insurance company; therefore you are responsible for payment whether or not your insurance company pays. It is your responsibility to contact your insurance company regarding pre-authorizations, obtaining required referrals, second opinions, etc. Failure to do so may reduce the amount of benefits paid by your insurance, and the balance will then become your responsibility to pay. All co-payments must be paid at the time of service.
 
NO INSURANCE: If you do not have insurance or the doctor is not a participating provider with your insurance plan, please be
prepared to fully cover the fees for each visit at the time of treatment unless other arrangements has been made with CMOCC prior to your appointment date.
 
PAYMENT: Payments for the balance due, co-payments, deductibles, etc., are due at the time of service and may be made by
cash, check or credit card (Visa, MasterCard, Discover). There will be a $35.00 charge for returned checks.
 
CO-PAYMENTS: Please be prepared to pay all co-payments at the time of service. We do not send bills out for co-payments, so your visit will have to be re-scheduled if you are not prepared to pay the co-payment. Per our contract with the insurance carriers, we can not submit a claim without first collecting the co-pay from the policy holder/dependents.
 
DEDUCTIBLES: If you have an annual deductible which has not yet been paid in full then any charges incurred up to that amount are due at the time of your visit.
 
DELINQUENT ACCOUNTS:  Any outstanding patient balances 30 days or more will be forwarded to CMOCC collection department. A 33.33% fee will be added to the balance by CMOCC collection department. The 33.33% will be paid by the patient, in addition to any court costs or fees if applicable.
 
MINOR PATIENTS: The adult or the parent (custodial guardian) accompanying a minor is responsible for payment of services. For unaccompanied minors, non-emergency treatment will be denied unless prior authorization from the parent or guardian has been made for the charges and treatment. Young adults (age 18 & over) are legally responsible for their accounts unless a parent accompanies them to the initial appointment and signs this financial agreement, regardless of insurance coverage.
 
MISSED APPOINTMENTS: Please help us serve you better by keeping scheduled appointments. If it is necessary to cancel,
please call our office 24 hours in advance. This allows us to accommodate our other patients. We reserve the right to charge a fee of $45.00 for missed appointments.
 
ORTHOTICS: Orthotics are a non-covered service by some insurance plans. Please check with your insurance company prior to
the examination and casting for orthotics to determine your orthotic benefits. A deposit of $150.00 is requested at the time of the
examination and casting and full payment is due when the orthotics are dispensed.
 
SUPPLIES: For your convenience we make some supplies available for purchase in the office. If you choose to purchase these
items, payment is due at time of purchase. We cannot bill for these items. In addition, we contract with outside suppliers to provide some supplies through our office. If any of these supplies are used for your treatment you or your insurance will be billed for these supplies by the outside provider. Advanced Foot and Ankle Care has no part in billing for these supplies.
 
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