Billing & Insurance
You will be billed for any service that your insurance carrier deems as your responsibility. If you insurance carrier does not respond or remit payment in full within sixty days, you will receive a bill for any balance due. There will be a $35 charge for any checks returned for non-sufficient funds.
- Familiarize yourself with your insurance benefits and what is not covered under your policy.
- Present your insurance card at each visit.
- All co-pays must be paid at the time of service.
- Familiarize yourself with your policy guidelines regarding emergency care, otherwise you may be responsible for payment.
Managed care referrals
Please allow four to five days to process your referral. We will contact you as soon as we have obtained authorization. If this is a true emergency, we will expedite the process.
We participate with Medicare and will file your claim for you. To do this, you need to provide a current Medicare Card. It is important to know that Medicare requires an annual deductible. You are responsible for this deductible as well as twenty percent of the Medicare approved amount.
Please note: Although routine and preventive health care services are important to your medical care, Medicare usually will not pay for these services. You will be asked to pay for non-covered services at the time of the visit.
If your coverage is through an HMO, the name of your Primary Care Physician (PCP) may be noted on your card. Your Primary Care Physician is responsible for coordinating all of your health care needs. Visits to specialists and outpatient services, i.e., laboratory and x-ray services, will only be approved if you obtain a written referral from your Primary Care Physician prior to your visit. You will be required to pay your co-pay at the time of service.
Note: Your PCP can only refer you to a specialist when it is medically necessary.
If you require emergency treatment, you must contact your Primary Care Physician prior to receiving treatment unless your condition is life threatening.
Unlike HMO’s, most PPO patients do not have a Primary Care Physician. They can choose any physician or site, provided the site or physician is contracted with the PPO. It is your responsibility to know if you have PPO coverage. It is sometimes easily identified by the letters PPO that may be noted on your card. It is important to know that if you visit a physician of site, lab, x-ray, etc., that is not contracted with your PPO, you will be subject to co-pays, deductibles and the out of plan co-insurance.
For OB patients with a co-insurance, you will receive in the mail, a payment agreement to show what amount you will be responsible for in addition to your monthly payment. If you disagree with the amount, please contact your insurance company and let our office know of any changes as soon as possible so we can amend the agreement.
No insurance or non-contracted insurance plan
Payment is expected at the time of the visit. As a courtesy, your insurance will be billed for any charges if you present a current insurance card at the time of service.
Many questions regarding your insurance coverage can be answered by reading and understanding your Plan booklet. If you have specific questions regarding your Plan, you should call member services. If your Plan does not pay for services, which you think they should cover, you should contact your employer’s benefits specialist, who negotiates directly with the insurance carrier.
If you have billing questions, contact the Billing Office at: 630-646-5662. Their hours of operation are: 8:00am – 4:30pm, Monday through Friday