Billing & Insurance
We encourage you to contact your benefits coordinator through your employer or contact your insurance carrier directly to verify your own benefits, eligibility, and other services that may or may not be covered. Whether you have insurance coverage or not, the party ultimately responsible for services provided by our office, staff and physicians will be you.
All services will be filed with your insurance carrier with the exception of records request, FMLA or other associated paperwork, cancellation notices and returned check fees. Any medical service(s) not covered by your insurance plan will become your financial responsibility.
If you have an HMO plan, it is your responsibility to ensure you have the appropriate referral from your primary care physician. If you do not have the appropriate referral and our office must obtain one, a fee of $25.00 will be applied to your account.
As of April 1, 2016 Dr. Smith will no longer be a Medicare provider. Dr. Smith has decided to stop participation as a Medicare provider due to the challenges in receiving payments from Medicare and the low reimbursement from Medicare for the type of care and surgery that he performs.
What this will mean for you is that if you want to see Dr. Sith in the office, you will need to pay for that office visit yourself. Dr. Smith will not bill Medicare for your visit and Medicare will not reimburse you for that visit. Medicare requires that you sign an agreement that states that you understand that you are seeing a non-Medicare provider, and therefore, you will not expect Medicare to pay for the care you receive from Dr. Smith, but rather, will be paying for that care yourself. Should Dr. Smith decide that surgery would be needed, he are required to make a similar agreement regarding the payment for surgery.
To be clear, you would only need to pay for Dr. Smith's professional fees. Any testing and the hospital fees related to surgery would still be covered and paid by Medicare.
Our office is happy to answer any question you have about this change. We are confident that if you feel your condition warrants the type of care we provide, you will find the benefits of Dr. Smith's care of value.