Billing & Payment
Frequently Asked Questions
Payment may have crossed in the mail. We will check your account to confirm receipt of your payment. If we are not showing receipt of payment, you may want to check with your bank or credit card company to confirm the transaction.
There are multiple reasons:
- Insurance on file is not in effect at time of service
- We have an incorrect insurance ID #
- We are not listed as your primary care physician
- You did not have a referral
- This is your remaining balance after insurance processed
- Services were not authorized
- Procedure or service is not covered by your plan
- Copay not paid at time of service
- Incorrect copay amount paid at time of service
Your deductible is an annual amount determined by your insurance plan, that they state is your responsibility and must be paid before they will pay your claims. Coinsurance is usually a percentage that your insurance company determines to be your responsibility once they process and pay your claim.
There are multiple reasons:
- Service may be considered experimental, such as B-12 for fatigue
- Certain vaccines are not covered under Medicare or Medicare HMO plans
- Some insurance policies do not cover services for weight loss or chiropractic care
You may have a copay, deductible or coinsurance under your plan which must be met before they will pay on your claim. Check with your insurance provider for coverage information.
Our office may not be listed under your insurance as your primary care provider, or your insurance company may have increased your copay.
If you are enrolled in a Managed Care Plan (HMO), you may be required to have a referral in order to see a specialist. Some procedures and services may require prior authorization under your insurance plan.
A referral is an approval from your insurance company to visit a specialist or a provider who is not your primary care physician.
An authorization is an approval from your insurance plan for a specialist or other physician to perform a service, such as a surgical procedure.
There are multiple reasons this may happen:
- Your copay may be higher than what was paid in the office
- You may have a copay that was not paid at the time of service
- Your insurance company may have applied a deductible or coinsurance
- You may have received a non-covered service
- Our office may not be listed as your primary care office
- We may not have your correct insurance information
- Your insurance company may be requesting information from you
If you feel you were billed, but you were not seen in our office, please contact us and we will pull the records for the date in dispute to verify this information. You may have been seen by a Physician’s Assistant, Nurse Practitioner, or another provider not yet recognized by your plan. In this case, the service was billed out under a physician authorized to oversee the provider you saw in the office.
If you are unable to pay your balance in full, we will gladly work with you to develop a reasonable payment plan to help you satisfy the balance on your account.
The codes and numbers you see on your bill are used to bill your insurance company for the services you received. They represent the office visit, the reason for your visit to the physician’s office, and are used to record your medical history.
Forward a copy of the patient’s death certificate, along with a letter of explanation. We will forward this information to the appropriate party to determine what can be done with the balance due.
Yes, we currently accept credit card payment over the phone.
An adjustment is the difference between what we bill to the insurance company, and the amount they determine to be reasonable and customary, or allowed. The difference between the two is deducted from the bill.
When there is a balance on an account, a reasonable number of statements will be mailed to the patient. If there is no response within that time period, the account will be sent to collections for further action. If you feel the amount you are being billed is incorrect, it is important to contact the billing office immediately.