PATIENT FINANCIAL POLICY

 

Self-Pay Accounts: Self-pay accounts are the accounts of patients without an insurance card on file. All accounts are deemed “self-pay” absent the patient providing proof of coverage. A predetermined minimum payment may be decided upon after speaking with our billing department, with payment to be made at the time of service (this payment will be applied to the total charges actually incurred, which may be more than the initial payment). As a courtesy, after the initial minimum payment, the balances may be paid in equal installments over a 90 day period. 

 

Network Insurance Plans contracting with The Family Physicians: The patient is expected to present an insurance card at each visit. All co-payments are due and payable at the time of service.

 

Insurance Plans not contracting with The Family Physicians: The patient is expected to present an insurance card at each visit. We will submit a claim to your insurance company. You may be responsible for a good faith payment at the time of service. After payment of all insurance coverage, patient will be billed for the remaining balance owed. As a courtesy, the remaining balances may be paid off in equal installments over a 90-day period, or a time frame discussed between the billing representative and patient.

 

Kansas Medical Assisted Programs: The patient or their guardian is responsible for providing proof of ongoing coverage. Absent proof, a patient is deemed to be “self-pay.” Dependent upon the specific plan, co-pays are required to be paid at the time of service.

 

Medicare: The Family Physicians will file claims and accept your Medicare assignment. The patient may be responsible for deductible/coinsurance amounts. Also, due to Medicare restrictions, certain services may not be covered. If there is a significant likelihood the service is not covered, the patient may be asked to sign a Medicare waiver, which acknowledges the responsibility for payment belongs with the patient. All deductible amounts shall be billed as with all other accounts.

 

Automobile Accident Cases: The automobile insurance company will be filed as a primary insurance, with your health insurance being filed after personal injury benefits have expired. If a patient has no health insurance above automobile insurance payments, their account will become treated as a “self-pay” account, subject to the policy outlined above.

 

 

Payment Options:

 

1. Health Insurance and Other Payment Plans:

As a service to our patients, The Family Physicians will file your insurance claims. These claims will be filed with health insurance policies, automobile insurance policies, Workman’s Compensation policies, and other payment plans. Unfortunately, not all services are paid by each insurance company or payment plan. Ultimately, the patient is financially responsible for the services provided. The clinic will send a final statement to the patient, once the insurance company or payment plan has responded to our claim. The patient, upon receipt of that statement, is obligated to pay the remaining balance in full.

 

2. Payment Plan:

The Family Physicians primary policy is payment in full for services, as billed. This policy allows the clinic to provide the best-rounded medical care that is reasonably possible for its patients. However, the clinic recognizes that individuals may not always be in a position where they can pay an account in full. In such situations, the clinic offers a payment plan policy as follows:

 

Office procedures, surgical procedures, and prenatal care

 

It is The Family Physicians' policy that the balance due, after the processing of insurance, be paid in full as billed. In some circumstances, the clinic recognizes that a patient may not be able to pay their balance in full. In such instances, upon consultation with the Patient Billing Department, a payment plan may be authorized. To arrange for such a payment plan, the patient should contact our Patient Accounts Department at 620-380-6615. Please see the payment plan form located at the top of the page for reference.

 

As a convenience for the patient, the clinic can arrange for an automatic draft from your checking or credit card account. There will be a service charge applied to any returned checks.

 

3. Credit Cards:

As a convenience for our patients, The Family Physicians gladly accepts your bank debit card, Visa, MasterCard, or Discover card.

 

Delinquent Accounts:

In situations where account balances are outstanding longer than 90 days, they will be considered for collection referral and you may be responsible for any collection fees from outside agencies and attorneys, unless other prior arrangements have been made with the Patient Billing Department at 620-380-6615. In unusual circumstances, the clinic reserves the right to require patients to be on a “cash only” basis for future services. In situations of significantly delinquent accounts, a process to terminate the doctor/patient relationship may commence. When we call to confirm your appointment we will also remind you that, if your account is past due, you will need to bring a payment. If that payment is not made at the time of your appointment you may be asked to reschedule for another date when the payment can be made.

 

The purpose of this financial policy is to help ensure the clinic’s ability to provide quality healthcare to all patients. Unpaid accounts diminish the resources available to provide quality healthcare. Thank you for your cooperation. If you have questions, please do not hesitate to contact Kaitlyn at 620-380-6615.

 

Contact The Family Physicians at (620) 365-3115 for answers to your questions about medical care or to schedule an appointment. The Family Physicians primary policy is payment in full for services, as billed.