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Billing and Payment Policy

ALBERT S. CALLIE, MD, PC

BILLING & PAYMENT POLICY

effective january 1, 2016

 

Insurance: We participate with many insurance plans. However, insurance plans change, so we ask you to know your benefits (copays, deductible, network, coinsurance, covered services, etc.) and to bring your insurance card to each visit. If your insurance changes please notify us before your next visit. If there is a lapse in insurance coverage, you will be expected to pay in full at the time of service for all appointments until insurance coverage is reinstated.

 

Copayments/Deductibles: It is your obligation to pay your co-payments, estimated deductibles and coinsurance, and non-covered services at the time of service. Whoever brings the patient (mom, dad, grandparent, aunt, etc.) into the office is expected to pay at check-in. Please contact your insurance company to determine deductible and other amounts prior to your appointment.

 

Claims Submission: We will submit your claims and assist in any way we can to get them paid. Your insurance company may need additional information from you directly. Please provide this information promptly. Please be aware, any unpaid balance (copays, deductibles, coinsurance, and non-covered services) is your responsibility.

 

Divorce/Shared Custody: Child custody arrangements have no impact on insurance. Whoever brings the child to the office is expected to pay the charges due for the service rendered that day. Albert S Callie, MD, PC does not participate in payment disputes between parents.

 

Billing Statement Procedure: If you have a balance you will receive up to two consecutive statements from our office. If we haven’t received full payment on your account after two statements have been sent, the account will be sent to an outside collection agency. If your account is sent to a collection agency, you will be given 30 days to select a new primary care physician.  During that 30-day period we will continue to provide only acute medical care for your child and full payment for services rendered will be due up front. We appreciate your prompt payment on outstanding balances.

 

Appointments: Unless it is a medical emergency, before scheduling an appointment for your child, you will need to pay off the outstanding guarantor balance (see above) or enroll in a payment plan to pay the balance within six months (see below). Because of the importance of staying on schedule and giving each child our time and care, all children will need a prior scheduled appointment. We may not be able to accommodate last minute requests to add sibling appointments.

 

Sick Care during a Well Exam: If in the course of a patient’s well exam a separate, non-well issue presents which needs to be addressed, it may be addressed during the current visit or at a subsequent visit. If addressed at the time of the current well exam, an additional E&M code (evaluation and management) will be added to the visit. Your insurance company may require a second co-pay or a deductible may apply for the additional service or procedure. Albert S. Callie, MD, PC will file your claim.  If the EOB (explanation of benefits) shows an additional amount is owed by the patient, you will receive a bill for that amount.

 

Payment Plans: Albert S. Callie, MD, PC’s policy is that any charges such as co-pays, deductibles, or non-covered services are due at the time of service.  However, we do offer a limited payment plan for those patients who are experiencing serious financial strain, with the following criteria:

 

  1. You must contact us promptly, at the date of service or upon receipt of the first statement.

  2. You will be required to provide us with a credit or debit card number to automatically process your payment on specified dates.

  3. The balance must be paid in full within six months of the date of service (unless otherwise specified), or six months from the date that we received payment from your insurance company (if applicable).

  4. A copy of this agreement will serve as your reminder.  Regular statements will not be mailed for this balance.

  5. No future charges may be added to this payment plan, as it is not intended to be a revolving charge account.  Until this initial payment agreement is paid in full, all future visit costs will be due in full at the time of service.

  6. If at any point you are unable to keep this payment agreement, and fail to notify Albert S. Callie, MD, PC, your account will be sent to a collection agency, and the above policy will apply.