It is important that you understand your financial responsibilities for the services you receive. The changing healthcare environment puts more of this responsibility in your hands.
If you have Insurance:
Our office participates in a variety of insurance plans. As a courtesy, we will verify your coverage and bill carriers on your behalf. It is your responsibility to: 1) bring your insurance card with you to every visit and make us aware of any changes in coverage, 2) bring a valid driver's license or state-issued ID to confirm identity, 3) check with your insurance plan to verify that APSI is in you Preferred Provider Organization (PPO) Network, and 4) if your insurance company requires a physician referral, it is your responsibility to ensure that one has been obtained. If a valid referral is not on file, you will be asked to pay in full for the office visit via check, credit card, or CareCredit.
*Co-payments and Deductibles: You are responsible for paying any co-payments, deductibles, or co-insurances at the time of your appointment.
*Secondary Insurance: Initial filing to your secondary insurance will be billed as a courtesy. You are responsible for the follow-up with your secondary insurance after it is initially filed by APSI.
Balance Billing - APSI will bill you for any services not covered by your insurance company. You have the right to appeal the decision directly with your insurance company. While in the appeal process, payment is required.
If you do not have Insurance:
Payment is due at the time of your appointment. Information regarding fees and payment plans is available through our staff representatives.
Payment Options:
We accept cashier’s checks, personal checks, debit cards, and credit card payments for your convenience. Upon request, CareCredit is also available and must be processed in person in the Blossom Hill location.
Financial Statements:
For your convenience, Statements will be sent electronically via text unless you request otherwise.
Motor Vehicle Accidents or Liability Cases:
We can file claims to your Automobile Insurance Company in cases where medical payment coverage is available from your Automobile Insurance Company to cover medical treatment/services rendered through APSI. In cases where such Med-Pay Insurance is not available and/or sufficient to cover medical expenses, within our standard guidelines, we will accept Letters of Guarantee and Liens to receive payment(s) when cases settle.
Worker’s Compensation:
We do accept Worker’s Compensation patients and file all claims to the carrier. There will be no balance billing to the patient for approved cases. You will be fully responsible for payment if Worker’s Compensation employer/carrier denies your claim. If you have received the authorized service at another clinic, as well as at our clinic, you will be fully responsible for the payment of that service. To increase convenience, efficiency, and control of pharmacologic care, insurance, and statute notwithstanding, we may be able to dispense certain recommended medications and durable medical equipment directly to you from APSI at the time of your doctor visit. As the injured party, you reserve the right to decline medication(s) and medical equipment(s) offered through APSI and obtain written prescriptions for equivalents to fill elsewhere. APSI will not knowingly collect or attempt to collect the payment of a charge for medical services or products (covered under Worker’s Compensation insurance) from a patient or the patient’s estate or family members.
Financial Arrangement for Surgery:
If your treatment includes surgery, APSI and affiliated ambulatory surgery center(s) will make attempts for pre-certification with your insurance carrier. We will also verify insurance benefits, obtain coinsurance and/or deductible information, and may request payment in advance.
Minor Patients:
A parent or legal guardian must accompany patients 17 years old and younger and sign as a responsible party below (Exception: patients 17 years and younger declared emancipated minors). It is the parent or guardian’s responsibility to bring the necessary referrals, and insurance card(s), and make payment at the time of service.
Non-Insured Services:
Our physicians will recommend medically appropriate treatment in all cases. If your health plan deems a service(s) medically unnecessary, experimental, non-covered, and/or inclusive, as the responsible party, you agree to pay for any amounts not covered by the carrier. We attempt to be familiar with the limitations of health plans; however, the patient/insured is principally responsible to know all his or her plan’s specific provisions.
Prior Authorizations:
Our physicians want our patients to be able to access the ancillary services, procedures, and diagnostic services that they feel you need to provide the best possible care and outcome. When a patient is using commercial insurance, workman's comp, personal injury claims, or other forms of coverage we must partner with those payors to approve the services in advance of treatment. Our office will advocate for you with the payors to complete the required prior authorizations for your treatment plan. Sometimes the authorization process can be completed very quickly, but sometimes due to circumstances beyond our control, there may be delays, denials, and appeals that are required, which can delay your treatment. Allied Pain & Spine completes prior authorizations as a courtesy, and we ask for your patience and participation in the process.
Returned Checks:
APSI will charge a $15.00 NSF fee for each returned personal check. This charge will be applied to the patient’s account. If two (2) checks are returned, only a cashier's check or a credit card will be accepted for future services.
Translation Services:
If you require translation services, you are strongly encouraged to ask a friend or family member, or your legal team to provide this assistance. If you cannot do so, and require assistance while in our office, we will use a third-party translation service to assist you. The cost of this service is $30 per 15 minutes of use. The cost will be collected at the time of requesting the service.
Accepted Payment Methods:
Allied Pain & Spine accepts personal checks, credit cards, debit cards, and Care Credit. APSI does not accept cash payments.
Medical Fees:
Our charges are determined by what is usual and customary to our specialty and area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates. Some treatment recommendations and services will not be covered by some insurance companies and will be the sole responsibility of the patient. If you have any questions about your billing statement, please ask to be referred to our billing department. Specific coverage issues, however, should be directed to your employer or insurance company’s member services department (the number found on the back of your insurance card).
Acupuncture and Chiropractic Fees:
Our charges are determined by the services the provider deemed would be most important for your care and by what is usual and customary for our ancillary providers in our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates. Some treatment recommendations and services will not be covered by some insurance companies and will be the sole responsibility of the patient. If you have any questions about what will be charged, please review with the provider before treatment begins.
Mental/Behavioral Health Assessments:
As part of APSI's holistic and integrated approach to the management of pain, you will be asked regularly by your providers to complete mental/health evaluations. Insights from these questionnaires are used by physicians at APSI to determine the impact of pain on your psychological well-being and to devise more personalized treatment approaches when addressing your problem(s). APSI will submit a claim to your insurance carrier for these periodic assessments.
Finance Charge:
APSI will charge a 1.5% finance charge on balances over 120 days.
Last-Minute Cancelation and Rescheduling Fee & No-Show Fee:
APSI requires 24-hour notice if a patient needs to cancel or reschedule an appointment. If an appointment falls on a Monday, patients must advise APSI of any changes on Friday before 2:00 pm. Failure to provide 24-hour notice will result in a charge of $80 to a credit card that we will ask to keep on file. APSI will charge a $80 NO SHOW Fee for any missed appointment not canceled within 24 hours of the appointment time. The charge for EMG/NCS Test last-minute cancelation, rescheduling, or NO SHOW is $275. The charge for a psychology appointment last-minute cancelation, rescheduling, or NO SHOW is $275.
NOTE: You are legally responsible for your account at APSI and all costs associated with its collection. Account balances after insurance must be paid in full within 30 days of patient billing unless other payment arrangements have been made to avoid collection agency action. A collection fee, attorney fee, or other fees that APSI may incur to collect payment will be added to any outstanding balance.