1. PAYMENT: payment is expected at the time of your visit. Just as we make every effort to accommodate you when you need medical care, we expect that you will make it every effort to pay your bill promptly. Payment is due at the time services are provided or upon receipt of the statement from the billing office. We will accept cash, checks, debit, or credit card. We also accept FSA and HSA card payments. Payment will include any unmade deductibles, Co-insurance, Copayment amount or non-covered charges from your insurance company. If you do not get insurance, or if your coverage is currently under a pre-existing condition clause, payment in full is expected at the time of your visit. We do ask for a copy of your current insurance card and driver’s license at the time of your visit, to ensure that we properly file your claim.
2. INSURANCE: We participate with several insurance plans and will file your claim on your behalf. Verification of participation with the patient's specific insurance plan is a responsibility of the patient. Patients are encouraged to contact their insurance carrier to ensure participation with the insurance plan prior to arriving for an appointment.
You are expected to present your insurance card at each visit. Insurance claims are filed to participating insurance companies. The patient is responsible for notifying our office of any changes in insurance coverage. Insurances often require a referral to be sent by your primary care provider with an authorization number, it’s patient’s responsibility to make sure their primary care provider has sent us the proper referral with a proper authorization/referral number which is required to submit your claim for the payment. If your insurance company decline to accept that authorization/referral number, it’s patient responsibility to make a full payment for date of service to the physician office.
3. SELF-PAY: payment in full is expected at the time of service for uninsured patients.
4. RETURN CHECKS: Checks returned for insufficient funds will incur a service charge currently set at $30, which may vary from time to time as determined by our financial institution. If your check is returned, it may be represented electronically. You authorize us the service charges and processing fee, as permitted by state law, to be debited from the same account by paper draft or electronically, at our option.
5. REFUNDS: Refunds are issued to patients when a patient overpayment has occurred and there are no outstanding claims to insurance or upcoming appointments scheduled
6. COLLECTION ACCOUNTS: All outstanding balances shall be due within 30 days of date of service. At that time all past due balances in their entirety must be paid prior to the time of your next visit. Balances that remain outstanding for a period of 30 day or more after the original billing statement maybe referred to a collection agency and could affect your credit.
7. FINANCIAL DISMISSAL: Patients who do not make payment arrangements, risk being dismissed from the practice. Dallas Arthritis and Autoimmune Disease Center reserves the right to dismiss patients for delinquent financial accounts on personal balances. If dismissed, medical care will not be withheld for a medical emergency for 30 days from the date of dismissal.
8. PAYMENTS AFTER DISSMISAL: If patient is dismissed from the practice at their own will or per our dismissal policy and for the reason of no further care required by this specialty, all the payments for the date of service are patient’s responsibility to pay in full, if services are not covered by their insurance.
9. RECOUPMENT OF PREVIOUS PAID SERVICE BY INSURANCE: Your insurance company may pay the balance for the date of service and later decide to recoup the money for any reason months and sometime years later. In that case it will be billed to you and it’s your responsibility to pay the amount in full.
10. FORMS: Form fees must be paid in full before forms are filled, for specific form fee please inquire our front desk staff.
11. MISSED APPOINTMENTS: If patient reschedules with a less than 24 hour notice, cancel, or No-Shows , the established patient will be charged a fee of $25 and new patient will be charged a fee of $50 before scheduling any further appointments.
12. METHOD OF PAYMENT: We accept cash, checks, debit card and credit card for payment. We also accept FSA and HSA card for payments. For any specific billing inquiries or to pay by phone with a credit or debit card please call 903-508-4230. Payment may also be mailed to Dallas Arthritis and Autoimmune Disease Center, 425 N highland Ave. STE 200, Sherman, Texas 75092. Checks are payable to: Dallas Arthritis and Autoimmune Disease Center OR Arthritis & Autoimmunity Clinic.
ACKNOWLEDGEMENT OF FINANCIAL POLICIES
I understand that I have received and understand the financial policy of the Dallas Arthritis and Autoimmune Disease Center. I have asked and cleared any questions I may have with the and I agree to the Dallas Arthritis and Autoimmune Disease Center financial policies.