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Frequently Asked
Insurance Questions
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Why do I have to show my insurance card every time I
come to see the doctor?
In general we ask to see your insurance card at each visit to make sure we send
the bill to the right insurance company the first time.
Can my child come to the doctor without me?
A parent or legal guardian must accompany patients who are minors.
Occasionally, other responsible adults (such as a grandparent) may need to bring
a child for a visit. In such cases we will need written authorization to provide
medical attention to the patient. The accompanying adult is responsible for
payment of the account, according to the policy outlined.
Why do I have to pay before a doctor sees me?
There are many reasons why we require payment before you are able to see the
doctor. The two most notable reasons are: (1)it speeds up the checking out
process once your visit is done, and (2) we can be assured of receiving payment.
What do I do if I think there is a mistake on my
bill?
We do not send bills showing insurance balances. If you receive a bill it is
because we show you owe the money personally. If you ever receive a bill and do
not understand it or do not agree with it, give us a call. We will get you in
touch with our billing department who will gladly go over your account with you.
In the event of a mistake, it may take a few days to resolve the problem. When
we have a resolution we will notify you either by phone or by letter.
Why do you bill more than my insurance will pay?
We deal with hundreds of insurance companies. Each one has their own fee
schedule, that is, the amount they will reimburse (or pay) for a particular
charge. Because we deal with so many fee schedules it makes sense to
charge one fee and adjust your account based on the reply from your insurance
company. With most plans we either have a contract (that binds us to a
particular fee schedule) or we “accept assignment,” which means we will accept
whatever they say is allowable. In a few cases we do not accept
assignment. In these cases we post the insurance’s payment to the patients
account then bill the patient for the remainder.
Why did I get a bill when I have insurance?
You may have received a bill from us simply because your insurance has applied
our service fees to your deductible or to coinsurance. If this is the case
please pay your bill within 14 days of the receipt of your bill. Your insurance
company may be asking questions to which we cannot provide the answer. Usually
these questions have to do with things like “do you have other insurance
coverage” or “what was the cause of an injury.” When you get such a
response you must reply to your insurance company. These balances will remain
your responsibility until either you pay or your insurance pays. Please do
not ignore these requests. Your bill is due within 14 days of its receipt.
You may be getting a bill because we have incomplete or inaccurate information,
or because we have had no response (payment) from your insurance company within
a reasonable amount of time. You bear the responsibility of making sure all of
our information about you is accurate and up-to-date. This would include
information such as your name as it appears on your insurance card, your address
and telephone number, where you work and your insurance coverage. Please
never ignore a bill. All bills are due within 14 days of their receipt.
What if the account is not paid?
We want to be understanding and cooperative with everyone in paying their
medical bill. If necessary, the staff in the Insurance and Billing Office, along
with management, will work with you in setting up payment arrangements. However,
for those patients who do not fulfill their obligations, it will be considered
in everyone’s best interest for those accounts to be referred to a collection
agency. Most patients sent to collections are simultaneously discharged from the
practice.
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