![]() Referrals must be presented to FPN office before seeing the doctor. I understand that FPN office staff will try to obtain referral, precertification, and eligibility, however the final responsibility lies with the patient to comply with their specific insurance requirements. Default on payment plan will result in balance being immediately referred to collection agency.ĬLAIM DENIALS: HMO/PPO claim denials due to cancelation of policy, lack of referral, lack of authorization, or reversals of authorizations are the patient’s responsibility regardless if previously obtained. Credit card must be on file for patient FPN revised New Patient Packet 2016 3 payment plans. If you have questions regarding outstanding balance you may contact billing office at FPN to set up a payment plan. If we have to refer your account to a collection agency a $50 collection agency fee will be added to your outstanding balance. A $25 dollar monthly statement fee will apply to any balance not payed within 30 days of the initial statement. If your account becomes past due we will take the necessary steps to collect this debt. Your account balance must be zero prior to your next visit with the physician. Failure to make payment on a past due balance before your next scheduled appointment will result in the cancelation and rescheduling of your appointment. Please pay your balance via the FPN Patient Portal, telephone or mail. Once a balance is past due payment will be required prior to your next appointment. PAST DUE BALANCES: Any balance more than 2 weeks (15 days) old will be considered past due. The patient will be personally and fully responsible for payment of that service.ĬHANGING INSURANCE CARRIER OR POLICY: Prior to your appointment it is your responsibility to notify FPN and provide new insurance information to ensure proper claim submission. If, your insurance plan determines that a particular service is not reasonable and necessary the insurance will deny payment for that service. PROCEDURES DEEMED MEDICALLY UNNECESSARY: Please be aware that certain services you receive may not be covered and/or may be considered “unreasonable” or “unnecessary” by your insurer. NON-INSURANCE PAYMENT: If your insurance does not issue payment within 30 days of the date that services are provided, the entire balance will become your responsibility. PRIVATE PAY/SELF-PAY PATIENTS: If you choose this option payment is due at the time of service. Services during gaps in insurance coverage are your responsibility. FPN will bill only once and when necessary will appeal once. FPN as of does not accept or bill tertiary insurance policies. FPN will provide you with your itemized statement in order to bill your respective insurances. Any confusion created by the patient with respect to multiple insurance plans resulting in non-payment of covered services immediately become the patient’s responsibility. It is the patient’s responsibility to clearly know and identify their primary insurance and their secondary insurance if this exists. While we are happy to help you receive the maximum benefits allowed by your insurance carrier, bear in mind that it is your responsibility to pay any copay, deductible, coinsurance or noncovered amounts not paid by your insurance company, prior to receiving services. FPN will verify insurance eligibility but we cannot verify that our physicians are in each individual’s network. It is your responsibility to verify with your particular plan that FPN physicians are in network. INSURANCE: Due to the large number of insurance plans and policies, it is the patient’s responsibility to know services covered by your plan. Your complete understanding of the financial policy is an essential element in your care and treatment. The financial policy is intended to eliminate financial confusion and misunderstanding between our patients and the practice. Furthermore, most insurance plans require deductibles and copayments not known to you or us at the time of your visit. As you may be aware, the current medical environment has resulted in employers and individuals selecting health care insurance policies that have increasingly transferred costs and more responsibilities to you, the insured. Please read carefully each statement and sign. Thank you for choosing Four Peaks Neurology as your care provider. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |