Financial Policy & Patient Agreement
Welcome to Anchorage Medical Services. Please take a moment to carefully review our Financial Policy. By signing, you acknowledge that you have read, understood, and agree to the terms outlined below.
AMS Urgent Care’s relationship is with you, the patient, not your insurance carrier. While we may submit claims on your behalf as a courtesy, you are ultimately responsible for all charges incurred.
By receiving services, you agree to the following:
- All copays, coinsurance, and deductibles are due at the time of service.
- If we are contracted with your insurance carrier, we will accept assignment per contract terms.
- Any remaining balance not covered by your insurance is your responsibility.
- Services deemed not medically necessary or not covered by your insurance plan are your responsibility.
- Providing complete and accurate insurance information is your responsibility; failure to do so may result in full personal financial responsibility.
Accounts not paid within 90 days may be referred to collections. You agree to pay reasonable collection costs, administrative fees, and returned check or chargeback fees as permitted under Alaska law.
Insurance Participation & Network Status
AMS Urgent Care participates with select insurance plans. Participation may change at any time. Eligibility and Benefits are determined by your plan. Verification by AMS is a courtesy, not a guarantee.
Current networks include:
- UnitedHealthcare
- Premera Blue Cross Blue Shield Networks
- Aetna Networks
- MODA
- Alaska State Medicaid
In-Network claims are submitted per our contracts. Out of Network claims may be submitted as a courtesy; full payment may be required at the time of service.
Insurance Billing & Place of Service
AMS bills under POS 11 – Office, in accordance with our enrollment and contracts. Some insurers may process claims differently than POS 20 (Urgent Care Facility), affecting copays, coinsurance, or deductible calculations. Cost estimates are provided as a courtesy and are not a guarantee of payment. Billing cannot be altered to change insurance processing or payment outcomes.
Minor Patients & Guarantor Responsibility
Parents, guardians, or legal representatives accompanying a minor are financially responsible for all services, regardless of custody arrangements or divorce decrees.
Self-Pay Patients
Full payment is due at the time of service. Discounted self-pay rates may be available.
Medicare
Medicare is administered by the Centers for Medicare & Medicaid Services (CMS). AMS does not bill Medicare and is not a participating provider for Medicare Part B. AMS does not provide inpatient hospital services and does not bill Medicare Part A. Some AMS providers have formally opted out of Medicare Part B in accordance with CMS regulations and see patients on a cash-pay basis only.
Medicaid
We only accept Alaska State Medicaid, aka. Denali Kid Care, Out-of-state Medicaid is not accepted. Patients over 18 are responsible for their copay at the time of visit. Voluntary procedures or services deemed not medically necessary are patient responsibility.
Worker’s Compensation
AMS Urgent Care can bill Alaska Worker’s Compensation when a Report of Injury have been filed, and the injury is verified with your employer. Complete billing information, including claim number, adjusting company, adjuster name and phone, and the correct date of injury must be provided within 10 days of treatment. If complete billing information is not provided within this timeframe, charges will become patient’s responsibility and accounts not paid within 90 days may be referred to collections
Federal or out-of-state Worker’s Compensation claims cannot be billed.
Automobile Accidents
AMS Urgent Care accepts auto accident injuries that occurred in the state of Alaska. If MedPay coverage is available through auto insurance, it must submitted prior to billing medical insurance.
Patients must provide complete claim information at check-in, including:
- Claim number
- Insurance company name
- Adjuster contact information
AMS does not bill third-party liability claims. If no applicable MedPay coverage or medical insurance is available, payment in full is due at the time of services. Patients are responsible for providing complete and accurate claim information; failure to do so may result in full personal financial responsibility.
Overpayments and Refunds
Overpayments will be refunded within 30 business days after final insurance payment or once the account shows a credit balance. Refunds are issued by check only. Credits under $10.00 will remain as a credit on file for future services unless a refund request is made by the patient. Patients are responsible for ensuring their address on file is current to avoid delays.
Acknowledgement and Signature
I acknowledge that I have received, read, and understand the AMS Urgent Care Financial & Insurance Policy. I acknowledge that I have been provided a copy of AMS Urgent Care’s Notice of Privacy Practices, which explains how my medical information may be used and disclosed. I agree to be responsible for payment of all services rendered, as outlined above.