Billing and Insurance Policy Pg 1.

1) Medical services are expected to be paid for at the time of service, unless we participate with a particular insurance carrier.

? Cash-pay patients are expected to pay the full balance of charges at the time of service.
? Insured patients with fixed co-pays must pay their co-pay before the office visit
? Insured patients with percentage co-pays must pay 20% of the charges at the time of service.
? Insured patients with deductibles are expected to pay the full charges up to the deductible amount at the time of service.
? Worker?s Comp or motor vehicle accident cases will be treated as cash-pay, unless the full insurance information is presented at the time of service.
? Any balance due from prior visits should be paid at the current office visit or arrangements made prior to being seen.

We accept cash, personal checks, MasterCard, Discover, American Express and Visa credit cards. If you are having problems paying your bill, tell us so we can assist you.
2) Insurance cards/proof of coverage must be presented at every visit.

? As a service to you, insurance claim forms will be filed for you (if needed). Insurance payments vary with the type of policy and insurance carrier. Check with your carrier if you have questions regarding your coverage. However, the charges resulting from the delivery of medical care are your responsibility.
? If you are covered by more than one insurance company, please let us know which company is primary (to be filed first and is responsible for payment first), and which is secondary (to be filed after the primary has paid). We cannot be responsible for knowing which insurance would be filed first.
? Medi-Cal/Central Coast Alliance patients must bring in both cards.

3) Please advise our office of any change in your address, phone number, marital status, insurance information, etc. that have occurred since your last visit.

? Any additional information requested by the insurance company to update their files, is YOUR responsibility. If payment of the claim is held up because of information you need to supply to your carrier, we will process this account and deal with the outstanding balance accordingly. Accounts are routinely turned over to a collection agency when payment has not been paid within a reasonable amount of time.
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