This Practice has contracts with most insurance companies. Effective January 22, 2020, the practice also participates in Medicare. If you obtain medical services from the Allergy and Asthma Center, you / or your beneficiary / legal representative accepts full responsibility for payment of the physician charges / services furnished by the physician after we receive the Explanation of Benefits from your insurance company. It is the patient's responsibility to check their benefits with their insurance company. We do not submit to secondary
It is the responsibility of the patient to make sure they have secured any referrals (for insurance purposes) that are required for their office visit; this referral will need to be provided at the time of the appointment. Patients / guardians are responsible for any outstanding balances that may arise out of not having the appropriate referral. If you are part of an HMO, you are responsible to obtain a referral from your primary care physician BEFORE your visit with us. If a referral is not obtained at the time of your visit, you will be responsible for the entire amount of the visit at the time of service.
If we have a contract with your plan, we will file a claim with your insurance company upon receipt of an updated insurance card. You are responsible for all charges that are not covered by your insurance company (i.e. deductibles, copays for a specialist visit, coinsurance These amounts will be due within one month of your visit. A bill will be sent out to your home once we get the EOB (explanation of benefits) from your
Your copay for a specialist office visits due at the time of your office visit.
We accept cash, checks, Visa, and MasterCard. There is a $50.00 charge for returned checks.
If you fail to pay your balance to the Allergy and Asthma Center and it becomes necessary to take action to collect on your account, you agree to pay for all costs in the collection of your balance including any collection
agency and / or attorney fees.
The Allergy and Asthma Center has a 24 hour cancellation policy. There is a $75.00 fee for missed new patient appointments and a $50.00 fee for missed follow up patient appointments and a $100.00 fee any
missed food, drug, or environmental challenge appointments.
There is a $50.00 fee for copying of any personal records and a $25.00 fee for filling out any school
I have read and understand the financial policy of the Allergy and Asthma Center and agree to comply with it.