Financial And Payment Policy


 

Financial and Payment Policy


Our physician is on most commercial insurance plans, PPOs, HMOs, and other provider networks.  We make every attempt to verify all insurance coverage prior to your visit and to obtain authorization for any procedures and/or diagnostic tests.  We may also attempt to obtain referrals if required by your insurance plan.  The patient is, however, ultimately responsible for his/her medical care.  If you are on a managed care plan in which we participate, you will be responsible for paying your co-payment and any outstanding balance at the time of service.  After your visit, your charges will be submitted to our billing service, and you will receive a statement for any additional amounts that are patient responsibility including coinsurance or unsatisfied deductible.

You are responsible for obtaining any necessary referrals from your primary care or referring physician and any precertification for procedures through your insurance.  If you are seen by our physician without an appropriate referral/precertification, you will be financially responsible for the amount of the visit if the visit is not covered or not paid by your insurance company for any reason, including lack of referral/precertification.

Our fees are generally considered to fall within the acceptable range by most insurance companies and are therefore covered as the maximum allowable, as determined by each carrier.  Some insurance companies utilize an arbitrary schedule of what they consider to be "UCR" (usual, customary and reasonable).  This bears no relationship with the current standard of cost of care in this area.  Please understand that we have an agreement with you and not with your insurance company.  We routinely make an effort to appeal any charges not covered, denied for experimental/investigational, deemed not medically necessary or denied as not covered under our contract; however, any charges not covered for any of the reasons listed above by your insurance company will be your financial responsibility.  Any claims not paid in a timely manner by your insurance company, regardless of any appeal or pending status will also be your responsibility, and payment will be expected from you.

As a courtesy to our patients, we will file your primary insurance for you, and we will file your secondary insurance if you have a supplement policy.  Workers' Compensation coverage will be verified; however, this does not guarantee payment.  In the event of a denial, your account and its balance will become your responsibility.

We accept cash, checks, and most major credit cards.

Special arrangements for payment will be made on a case-by-case basis, and payment plans may be established.  Please address any questions about our financial and payment policies with the Office Manager.

 

CO-PAYMENTS ARE DUE AT THE TIME OF SERVICE.  IF YOU ARE UNABLE TO PAY YOUR COPAY, YOU MAY NEED TO RE-SCHEDULE YOUR APPOINTMENT.

ANY RETURNED PAYMENTS WILL BE ASSESSED A $35.00 SERVICE CHARGE.

THERE WILL BE A $25 NO SHOW FEE ADDED TO YOUR ACCOUNT IF YOU MISS YOUR APPOINTMENT.  THERE WILL BE A $100 NO SHOW FEE ADDED TO YOUR ACCOUNT IF YOU MISS A SCHEDULED PROCEDURE.

THERE WILL BE A $25 CANCELLATION FEE IF YOU CANCEL YOUR APPOINTMENT WITH LESS THAN 24 HOURS NOTICE.  THERE WILL BE A $100 CANCELLATION FEE IF YOU CANCEL YOUR PROCEDURE WITH LESS THAN 24 HOURS NOTICE.

Location
Bender Orthopaedics & Spine Specialist
11660 Alpharetta Highway, Suite 630
Roswell, GA 30076
Phone: 678-274-6717
Fax: 678-297-7587
Office Hours

Get in touch

678-274-6717