Hellman & Rosen Endocrine Associates

Policies

INSURANCE (in-network):

Our office is not responsible for obtaining payment from the insurance company. We will file your insurance claim as a courtesy to you; however, your insurance policy is a contract between you and your insurance company, and payment for services rendered is ultimately your responsibility, whether or not your insurance company pays for these services. Your are responsible for ensuring that your insurance company pays in a timely fashion, and you will need to contact your insurance company if your claim has not been processed within 45 days. If your claim remains unpaid after 60 days it will be considered past due, and we will expect prompt personal payment of the balance due.

INSURANCE (out-of-network):

PPO: We will file your insurance claim as a courtesy to you, but your personal responsibility (coinsurance and deductible) will be higher than if you receive services from an in-network physician. If your insurance company denies payment for services, you will be responsible for full payment of the balance due.

HMO: Most HMO plans do not have benefits for out-of-network services. Please verify if your insurance plan has out-of-network benefits. If there are no out-of-network benefits, your account will be subject to the "self-pay" guidelines.

SELF-PAY (no insurance):

Payment in full is expected at the time of service, unless other arrangements are made before the services are provided. Our billing department will be happy to speak with you regarding your account prior to your appointment, either by telephone or in person at the office.

IN-HOUSE SERVICES:

Laboratory Services: It is our policy to perform laboratory services in-house to ensure high quality and timeliness of results. We do not utilize outside laboratories for tests that we can perform in-house. We do not honor laboratory insurance that requires us to send tests to an outside laboratory; however, we will bill your insurance company for these procedures. If we contract with your insurance plan, we will accept their contractual write-off for these services. Generally, laboratory services performed at our office are subject to the deductible and coinsurance requirements of your policy.

Dexascan (bone density study): Your insurance company may not pay for a bone density study obtained for diagnostic purposes. We cannot verify payment for this service prior to submission and processing of the claim. We will obtain proper pre-authorization when required; however, pre-authorization is not a guarantee of payment. If your insurance company denies payment for your Dexascan, you will be responsible for payment.

PATIENT NO-SHOW AND LATE CANCELLATION POLICY: Revised 02/27/17

At Hellman & Rosen Endocrine Associates, our goal is to meet and exceed the expectations of all our patients, and to provide you with the highest quality care and services possible. Time is specifically reserved for you on our schedule when you make an appointment, and our appointments are increasingly in short supply. Each time a patient misses an appointment without providing proper notice, another patient is prevented from receiving care. We have an extensive waiting list, and because of our desire to protect all our patients who really want or need an appointment, we are modifying our no-show and late cancellation policy.

Hellman & Rosen Endocrine Associates will charge no-show (failure to keep or cancel a scheduled appointment) and late cancellation (appointments cancelled with less than two business days' notice, excluding weekends) fees as outlined below:

No-Show fees:

Physician, Physician Assistant, Nurse Practitioner, or Clinical Psychologist ... $100.00

Dietitian, Certified Diabetes Educator, Laboratory, Nursing .......... $ 60.00

Late Cancellation fees:

Physician, Physician Assistant, Nurse Practitioner, or Clinical Psychologist ... $ 50.00

Dietitian, Certified Diabetes Educator, Laboratory, Nursing .......... $ 30.00

These fees will be billed directly to the patient, are not covered by insurance, and must be paid prior to scheduling another appointment. If a future appointment is already scheduled, the fee must be paid at least one week prior to the appointment or the appointment will be canceled by the practice. We do understand that emergencies arise and that it may not be possible to give such notice. If an emergency situation arises which precludes your ability to cancel prior to two business days ahead of your appointment, you must explain the circumstance to our office and waiver of this fee may be considered by Administration.

Multiple no-shows or late cancellations (three or more) in any 12-month period may result in your dismissal from the practice.

Thank you for your understanding and cooperation as we strive to best serve the needs of all of our patients. By providing us with at least three business days' notice of the need to cancel, we will be able to accommodate other patients with the appointment slot.

If you are unable to keep your scheduled appointment, we want to remind you of the importance of follow up treatments as indicated by your physician.

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