Urologic Specialists of Northwest Indiana Statement of Financial Policy
Thank you for choosing Urologic Specialists of Northwest Indiana as your health care provider. We are committed to the success of your treatment and care. Please understand that payment for service is part of this process. The following is our Statement of Financial Policy, which we request all of our patients to read, understand, and sign prior to any treatment or care.
When Is Payment Due?
Payment is due at the time services are rendered in the office. To see how this affects your specific insurance situation, please read the “About Your Insurance Coverage” section of this policy thoroughly.
Methods of Payment
We accept cash, checks, VISA and MasterCard. We offer payment plans and are happy to provide financial counseling if necessary. Please ask for the Practice Manager if you wish to discuss alternate payment methods.
About The Fees We Charge
You may notice information on your Explanation of Benefits forms that relate to “usual and customary” fees. You should understand that Urologic Specialists of Northwest Indiana fees are in-line with other physician groups in the area. We have completed a full analysis of our fee schedule using the McGraw-Hill Relative Values for Physicians. This is an industry-standard tool to determine fees and is used by Blue Cross Blue Shield plans in at least 16 states, as well as hundreds of other insurance companies and managed care plans, In addition, we have compared our fees to payments by managed care plans and insurance companies in NW Indiana and feel confident our charges are appropriate.
Patients Who Are Minors
The adult accompanying a minor and the parents (or guardians) are responsible for payment. For unaccompanied minors, non-emergency treatment will be denied unless charges have been pre-authorized to an approved credit plan, VISA/MasterCard, or payment is made by cash or check at the time of service.
About Your Insurance Coverage
The amount that is due at the time of service may vary, according to your insurance policy.
Please note the following guidelines:
Commercial insurance- also known as indemnity insurance, or “80%/20% coverage.”
If you have commercial insurance, you will be asked to pay your entire balance at the time services are rendered in the office. We will then file your insurance claim for you, and the insurance company will mail the reimbursement check directly to you.
Please note that your commercial policy is a contract between you and the insurance company. Because we are not part of that contract, your account balance is your responsibility whether the insurance company pays or not.
Managed care plan- also known as an HMO, PPO, POS or EPO.
If we participate with your plan, we will accept the appropriate co-pay as payment in full at the time of service. You will not be asked to pay the full charge. We will then file your insurance claim for you. In the case of some PPOs and POS plans, we may later send you a statement for the amount, which is your responsibility, according to the terms of your policy. Please be aware that some services may not be a covered benefit under your managed care plan. In that case, all non-covered services are your responsibility to pay in full the day services are provided.
Urologic Specialists of Northwest Indiana participates in the Medicare program. This means we accept payment of the Medicare allowable as payment in full – Medicare pays 80% of this allowable, and beneficiary is responsible for the remaining 20%. Medicare patients will be asked to pay their deductible at the time of their visit, if it is not yet paid. Once it has been met, the following policy applies to our Medicare patients.
If Medicare is your primary insurance, and you also have secondary coverage, we will file your claims for you. No payment is necessary at the time of service. Medicare will automatically transfer 20% to your secondary insurer, and send payment directly to our office. If Medicare is your primary insurance, and you do not have secondary coverage, we will ask that the 20% copay be paid at the time of service. Our staff has already calculated these amounts, and will inform you about your responsibility.
If you are a Medicaid patient, we will file your claim for you. You will not be asked to pay at the time of service.
If you do not have insurance coverage, payment in full is requested at the time of service. If you are unable to pay for your service in full, please ask to speak with our practice manager to discuss financial arrangements.
If you have questions or concerns about our financial policy, please feel free to call for further information.