Payment Policy
Thank you for choosing us as your OB/GYN provider. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered we have been advised to develop this payment policy. Please read it and ask us any questions you may have. A copy will be provided to you upon request.
1. Insurance. We participate in most insurance plans, including Medicare. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.
2. Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your copayment at each visit. A $30 fee will be assessed for each returned check.
3. Non-covered services. Please be aware that some - and perhaps all - of the services you receive may be non- covered or not considered reasonable or necessary by Medicare or other insurers, You must pay for these services in full at the time of visit.
4. Proof of insurance. All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance card to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
5. Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim, Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
6. Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in SO days, the balance will automatically be billed to you.
7. Nonpayment. If your account is over 90 days past due, you will receive a letter stating that you have 14 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that ii a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.
8. Laboratory Fees. Fees for services performed by an outside laboratory are your responsibility. if you should have any questions regarding those fees, please direct your calls to the telephone number on your bill.
Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area.
Insurance
All co-payments or payments are expected at the time of your visit. We will be happy to assist you in filing insurance or disability claims. If for some reason you cannot pay your bill in the specified time, please speak with our financial counselor. We’ll do our best to work out a payment plan with you.
Bring your insurance card and physician referral (if required) to your appointment. Prince William OB/GYN Associates belongs to most insurance plans, HMOs and PPOs. As this list constantly changes, please check with our business office for the latest update. Please notify us if your insurance coverage changes for any reason. At this time TRI-Care and Kaiser patients may only be seen on an “out of network’ basis. We do not accept any new obstetrical patients with Medicaid. GYN Medicaid patients are seen on referral only.
The Virginia Legislature has passed legislation giving women open access to their gynecologist. Many insurance plans interpret this to suggest you can visit our office anytime for a GYN or OB visit without a referral from your primary care doctor A few plans limit you to one routine check-up a year. For those plans where a primary care physician is assigned, the managed care program usually requires a patient to contact the primary care physician first before calling our office with general health related questions or for referral to other specialists. if you have any questions about your plan, please check with our staff,
Managed care plans may have restrictions with respect to hospitals, referrals, as well as the type and extent of treatment approved. Changes in hospitals, labs, and ancillary service providers occur continuously. While we make every effort to keep abreast of these changes and relay them to you, it is ultimately the patient’s responsibility to make certain her insurance approves of the hospital, physician or lab where she has been referred. We recommend careful review of your plan’s benefits and suggest contacting your program’s patient relations representative for problems. We will be glad to assist you in any way we can.