Financial Policy

Roberta June Guibord, DO Contents Patient Resources Financial Policy

 

We recognize the need for patients to understand what is expected of them and what they may expect, regarding financial arrangements for medical care. It is our hope that our patients will understand that many of these credit and collection policies are required by state and federal laws and to assure the financial resources necessary to provide quality medical care to the community. The existence of a formal financial policy does not circumvent our sensitivity to the needs of our patients. We encourage contact with our billing office if a problem regarding your account should arise. Our financial policy is as follows, is applicable to all patients and effective immediately. 

  1. It is the patient’s responsibility to know what services are covered or non-covered under their health insurance policy. Many procedures, while excellent relative to a patient’s overall care, are considered preventive and are not covered by some insurance plans. Examples of these services are routine PAP smears, screening PSA’s (prostate cancer screening blood test), screening colonoscopies when there is a strong family history of cancer of the colon, sports physical, work physical, etc. Check with your insurer to see if these services are covered prior to scheduling any test or procedure.
  2. Likewise, it is the patient’s responsibility to know if a referral is required from their insurance carrier to see a specialist and to make certain the referral has been requested from their insurer. The patient will be financially responsible for any charges subsequently denied by their insurer in the absence of an appropriate referral.
  3. All co-payments are due and payable at the time of service, in accordance with state and federal legal requirements for collecting patient responsibility amounts.
  4. Insurance claims for our services will be submitted to your primary and secondary insurer. It is the patient’s responsibility to provide our office with up-to-date and accurate insurance information. If you information is inaccurate and we are unable to file a claim, you will be billed privately for those charges. Ultimately, the patient is responsible for payment of any services provided to them or their covered dependents.
  5. Once the insurer has paid the claim, any deductibles, co-payment amounts, or non-covered services will become the responsibility of the patient. Prompt payment is expected, once a statement has been received (within 30 days). If that is not possible, please contact our billing office.
  6. We are participating providers with most insurance plans. Participation means we will accept what the insurer approves as payment in full, exclusive of any patient responsibility amounts, such as co-insurance, co- payment amounts, deductible amounts or non-covered services. The insurer may pay only a percentage of the approved amount, with the remainder payable by the patient or by their secondary insurance policy. We are required by state and federal laws to collect patient responsibility amounts for both federally funded programs and private insurers.
  7. We are happy to provide treatment for injuries related to auto accidents for our established patients; however, the payment for these services will not be contingent upon a settlement from the accident insurer. It is the patient’s responsibility to make arrangements for payment of service rendered to them as the result of an auto accident. Compensation to the patient for the payments they have made for our medical services can be directly negotiated between the accident insurer and the patient.
  8. It is responsibility of those patients who receive benefits from the Ohio Department of Jobs and Family Services to provide us with a current copy of their card. Failure to provide verification of current benefits (a new card is issued every 30 days) will be financially responsible for any services provided to them as well as any non-covered services.
  9. All patients may receive monthly statements from our office, even if their insurers are still processing the claims for services. These statements are informational, until such time as there is an amount listed in the “Patient Responsibility” column. Any amount so listed is due and payable upon receipt of the statement.
  10. Any account delinquent for period of 120days will be referred to an outside collection agency and could result in the termination of patient care from the practice.