Financial Policy

We are dedicated to providing you with the highest level of care and service and want to meet or exceed your expectations. Your understanding of and compliance with our financial policies and procedures is important. Considerable care has been taken in setting our fees. Our charges accurately reflect the complexity of care rendered and the skill and expertise required for your care.

All professional services are charged directly to the patient. Insurance coverage has become a very complicated and complex area. Each policy has its own set of rules, guidelines and benefits. It is vital that you, the patient, understand and know the rules and benefits of your policy.

It is our policy to inform you of our patient payment procedure. Please refer to the section(s) below that is applicable to you.

PERSONAL HEALTH INSURANCE
You are responsible for deductibles, co-pays, non-covered services, coinsurance and items considered “not medically necessary” by your insurance company. The co-pay amount is due as services are rendered. The remaining balance is to be taken care of within 30 days of notice from the office. If you are not able to pay your balance in full, you must call the office and set up payment arrangements. Insurance card(s) must be presented each visit.

MEDICARE
Our office will submit your charges to Medicare and your secondary insurance. You are responsible for deductibles, co-pays, any non-covered services, coinsurance, and items considered “not medically necessary” by your insurance company. The co-pay amount is due as services are rendered. The remaining balance should be taken care of within 30 days of notice from the office. If you are not able to pay your balance in full in 30 days, you must call the office and set up payment arrangements.

MEDICAID (We participate with Buckeye Community Health Plan Managed Care Program).

A current Medicaid card MUST be presented to the front desk before each visit otherwise the office visit will be a cash visit.

WORKER'S COMPENSATION
We are not certified by the Bureau of Worker's Compensation to treat injuries related to your work. Please check with your employer for a list of physicians on your MSO.

SELF PAY
Payment in full is due at the time of service unless you make other arrangements in advance with an account representative in our billing department. A 20% discount will be given to patients with no insurance when the bill is paid at the time of service.

AUTOMOBILE ACCIDENT
You are responsible for the payment of these charges. We realize that an insurance company may be paying for medical services rendered as a result of an auto accident, but some of these cases take years until a final settlement is reached. We will give you the proper billing paperwork to file your claim. If you are unable to pay for your visits on the date of service, you must call the office and set up arrangements with the billing department.

DISABILITY FORMS
A fee is required to be paid prior to the completion of disability forms.

COPIES OF MEDICAL RECORDS
We will provide copies of part or all of your medical records upon written request. Fees for searching, copying and mailing will be assessed in accordance with Ohio law.

NO CALL/ NO SHOW – Any “No Call/ No Show” will be billed to the patient. The fee is $25.00. It must be paid before the next office visit is scheduled or by notification due date, which ever comes first.

We accept cash, check, Money Order, Master Card, Visa and Discover. Returned checks (NSF) non sufficient funds will receive an overdraft charge plus a collection charge and must be paid before any other visits. If you or your insurance carrier overpays your balance, the credit will be refunded. In case of hardship, a payment plan may be established through our billing department. A collection agency may take over a delinquent account. If your account is placed with a collection agency, you will be responsible for all costs of collection. Failure to pay your account in full or to make arrangements for payment will result in dismissal from the practice