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| Office Policies |
In order to give you the the very best in medical service,
the following policies have been adopted for the general good of all patients.
We appreciate your cooperation in helping us, help you! |
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General Information: New Patients | Financial Policy | Personal Information Files | Payment Policies
Other charges: Service Charges, Insufficient Funds, Lab, Referrals | Accepted Insurances | Forms of Payment |Filing Insurance | Ultimate Financial Responsibility | Supplement Purchases
Appointments: Missed, Follow-up, No Charge, Extended, Taking Too Long | Medicaid | Medicare | Financial Representative |
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New Patients - Welcome to our office! We are glad you have chosen NEWS to help you care for your health.
Please be aware that Dr. Schultz and many of our patients are highly allergic to perfumes, body lotions, and creams.
Please do not wear any of these to any of your visits. If you do, your visit may have to be rescheduled.
Insurance coverage.
All insurances are accepted at NEWS; however we only accept assignment and file claims on Dr. Melville's patients for BC/BS PPO's. Dr. Schultz is "fee-for-service" payable in-full at the time of service. To assist all "fee-for-service" patients in collecting from your insurance company, we provide a walk-out Superbill. You need to use this Superbill to file your insurance claim. If you have any questions about this process please contact Ms. Kristen, our billing representative.
We understand that with the high premiums that you pay for health insurance, you expect your insurance company to pay for all of your care. This seems reasonable. Unfortunately, health insurance is more like auto collision insurance - it does 't pay for repairs, tune-ups, or new tires - it only pays for accidental damage repair. This means that while some of your care may be covered, some of your care, especially the specialized testing and Preventive Healthcare that we offer here at NEWS, will be your responsibility.
We look forward to the day that brings change to the "sick care" medical system in our country. Perhaps a new system with insurance coverage limited to emergencies and crisis care will result in premiums much lower so everyone can afford catastrophic health care. The major savings will be in a shift from our present "crisis care" to "consumer directed individualized preventive health care." That system would allow you to choose the kind of maintenance healthcare your really want and need. NEWS feels that we are already functioning by that medical "health care" model. Thus by allowing us to help you maintain or improve your health status we save you medical care dollars.
We encourage Savings Medical Account plans (SMA's) for the self-employed and Flex Plans for employees who can take advantage of this flexibility now.
Please feel free to call us (or e-mail) for assistance with any of these matters.
Initial Visit and Important Papers:
If you have insurance coverage, it is important to bring your insurance card with you to the first visit. All lab work is submitted with insurance data. If we don't have your insurance information, you will be billed, by the lab, for the lab work. We have no other choice.
Be sure to bring, or arrange to have forwarded, before your appointment, any pertinent old records (especially lab work, mammogram's, Pap's, bone densities, ultra sounds). Please use the following Medical Records Release Form to forward those records.
Bring to initial visit:
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Insurance card
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Old records
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Completed, on-line office visit forms
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1. NEWS's Financial Policy-
a. Is available on our Internet Website [www.noaw.com] and in print in our Office Policy and Procedures Manual.
2. Personal information files -
a. Will need to be updated on each patient every year
3. Payment Policies for Office Visits and Procedures:
a. It is NEWS's office policy to collect full payment for services rendered at the time of each and every visit.
b. Dr. Melville's first time BC/BS PPO patients, all other insured patients and all fee-for-service patients will be expected to pay their entire bill at the time of service.
c. Once Dr. Melville's BC/BS patients have established insurance coverage, this means we are paid by your insurance company for your initial visit, we will expect payment of your yearly deductible and co-pay at the time of service. However, until we receive that initial payment, all office encounters will need to be paid in full. Your initial payment [and any other payments in full] will be refunded back to you once we have been paid for those individual visits.
d. Failure for anyone to pay his or her co-payment at the time of service, will make it impossible for us to provide further care until the bad debit is paid
4. Why do we require payment at the time of your visit?
a. Unlike many other physicians' offices, our practice does not do expensive procedures that help us meet our overhead. Thus, everyone is expected to pay when services are rendered. Please understand that the doctor's services are provided directly to you and not to an insurance company. We simply cannot afford to render services on the assumption that charges will eventually be paid by the insurance company. You are ultimately responsible for the charges for your visit.
b. Prompt payment at the time of service decreases the time, money and energy spent in billing and mailings which then allows us to contain cost and not have to pass them on to you in the form of higher office charges
c. When payment is made at the time of service, it is a win-win situation for both of us.
5. Other charges
a. Service Charges:
A service charge of $3 will be added to all statements sent in an attempt to collect outstanding debit. Service charges will not be added to the initial statement sent after insurance payment is posted but any additional statements will be billed the $3.
b. Charge for Insufficient Funds check:
Returned checks are charged a $30 fee for processing. This processing fee and returned check must be paid before further care is rendered.
c. Lab Fees:
---- 1. A drawing fee will be charged if NEWS's staff or physicians draw your blood. This fee is actually charged by the LabCorp technician
when they draw your blood. It is just that it is billed to your insurance company by the
them and not us. LabCorp still charges us for the lab drawn fee and thus we have to collect it from you.
---- 2. The lab entity itself will either bill your insurance company or you for the cost of the labs.
---- 3. Self pay patients will be responsible for all lab costs. These fees are not included in the office visit.
---- 4. Any Specialty Lab Test performed on any patient will be the responsibility of the patient.
6. Referrals
a. All referrals from our office to anyone or any facility are the soul responsibility of the patient.
b. It is the patient's responsibility to call their insurance company and be sure they don't need prior authorization. Failure to obtain prior authorization is the patient's responsibility.
7. Allowable forms of payment:
a. We accept VISA, Master Card, American Express, Discover as well as checks or cash.
8. Accepted Insurances:
a. All insurances are accepted at NEWS but we only accept assignment on BC/BS - PPO's and only on Dr. Melville's patients.
b. All other practitioners are fee-for-service and payment is expected at the time of service.
8. Filing Insurance
a. All patients, no matter their mode of payment, will receive a Superbill that may
be used to file insurance for reimbursement.
b. NEWS will only file BC/BS insurance claims for Dr. Melville's patients since he takes assignment on these insurances.
c. All others with various insurances will have to file their own insurance. You will be given a Superbill with all the information you will need to file your insurance. Please be sure that all of the coding numbers you will need are present on the Superbill.
d. If this is the first time you have filed your insurance and you are unsure how to do this, please consult Miss Kristen. She will be glad to instruct you in the procedure.
9. Ultimately the Patient is Financially Responsible for the Total Charge
a. All fees generated at NEWS are the ultimate responsibility of the patient.
b. Just having insurance does not guarantee the ultimate or timely payment of your services.
c. Many times insurance companies slow these payments down by requesting records from NEWS, from you the patient, or from prior physicians.
d. If after three months of non-payment by the insurance company, the bill will be submitted to the patient for payment. Payment in full will be expected. Any future payments, by the insurance company, on this encounter will be reimbursed to the patient.
e. If you or your dependents have a delinquent insurance account, we will not provide routine services until the balance is paid in full.
f. Many times what it takes is patient involvement to get claims paid. We will help in any way possible to speed this process, but the speed of payment is out of our hands and in yours.. You pay the insurance company for the policy, not us!
10. What if I need a costly procedure and I don't have the money?
a. Truth-in-Lending forms must be signed prior to the procedure. You will be expected to pay 20% of the total cost the day of the procedure. The remaining balance will need to be paid within the ensuing 3 months. Missing a monthly-pre-arranged payment, without contacting us, will constitute intended nonpayment for the remaining balance. Without further attempt to collect on this debit, we will turn it over to our collection agency.
11. Supplement Purchases
a. All supplements purchased in the office, will be paid for in full at the time of
purchase.
b. A bill will be issued that you may use for reimbursement from your insurance company. Some insurance companies are recognizing the importance of these adjuncts to health care, but until this is the rule rather the exception, you will be responsible for the purchase of these products.
c. Supplements may NOT be returned.
12. Missed Appointments
a. NEWS attempts to notify all patients of impending appointments.
b. When a patient fails to present for a scheduled appointment, it has a detrimental effect on the schedules of other patients. Our physicians spend 1 to 1.5 hours on initial histories and physicals. When these appointments are missed, a significant amount of time is lost that could have been used to care for other patients. We take time with our patients, so we do not "double-book".
c. We also have a waiting list, thus a cancellation notice from patients usually will allow us to fill this appointment. We ask for your cooperation in this matter. Please be considerate of other patients needs. Thus, we expect a:
---- 48 hour cancellation for new patients, physicals, and procedures
---- 48-hour cancellation for established follow-up patients.
---- Cancellations made over the weekend, via our answering machine, will be viewed as a 24 hour notice. Thus if you will not be making a Monday appointment, you need to call Friday before 4:30 PM to cancel.
d. Failure to cancel your appointment in a timely manner will result in the following discretionary charges:
---- New patient appointment, physical, or procedure = $50
---- All other missed appointments = $25
13. Follow Up Appointments:
a. You should plan to arrive for follow-up appointments at least 10 minutes before the appointment time to allow for check-in.
b. If you arrive late, we cannot guarantee that you will be seen.
c. If you arrive late and we are able to see you, your appointment may be shorter, but you will still have to pay the full appointment fee.
14. "No charge" appointments:
a. If "No Charge Appointments" are not canceled or rescheduled by noon at least one business day in advance of the appointment, they will be rescheduled as a charged appointment.
15. Extended Appointments
a. If an appointment takes longer than the time originally scheduled, you will be charged for a longer appointment. This includes both new patient appointments and follow-up visits.
16. Your Appointment is taking longer than you expected!
a. Our physicians try to meet the needs of patients as they go through the day. Some days, patients have more immediate problems than time is allowing and the physicians get backed up. If the physician is taking more than 20 to 30 minutes to get in to see you and you cannot wait, please reschedule your visit. We try and prevent these delays but most of the time we have no control over them.
b. In our 30+ years of seeing patients, we have tried everything to prevent delays nothing has worked. Please be assured that you too will be afforded the time you need when your time comes. We appreciate everyone's concern for the other patients in the office that day.
17. Medicaid
a. NEWS is NOT a Medicaid provider.
18. Medicare
a. As our established patients move into "Medicare status", we continue to see them. We do not, however, actively accept New Medicare patients. Our established patients need to understand that Medicare will not cover Preventative Healthcare and secondary health care policies might not either. Thus the total sum of Preventative Healthcare you receive after you accept Medicare comes out of your pocket and no one else's! You will be responsible for the preventative and non-covered costs of your health care when an active Medicare patient at NEWS. This is true in ANY physician's office.
b. Special arrangements can be made to see folks on Medicare if they maintain their present Family Physician for Medicare health care and pay "out-of-pocket" for Preventative Healthcare from NEWS.
19. Financial Policy Representative
a. We regret any inconvenience these policies may cause you and welcome the opportunity to discuss any aspect of our financial policy. The policies have been developed for the common good of all of our patients. We will gladly entertain any suggestions.
b. Miss Kristen is our billing office representative. Please contact her with your questions. If she cannot answer your concerns and questions, she will contact the doctor the concern is related to. This will take time to accomplish.
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Revised last: 5/2010
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