Financial Policy

*Policy Summary

INSURANCE: We accept most commercial insurance plans including Medicare Part B and Tricare.
A health insurance
policy is a contract between you the Patient/Subscriber and
your insurance carrier. We will submit the claim to your insurance provider on your behalf if you have provided the necessary information such as photo ID, SSN, valid insurance card, referrals, and preauthorization.
Failure to provide insurance requirements will result in
payment responsibility by the Patient/Subscriber. If for any reason the insurance carrier does not pay the claim, Patient/Subscriber is responsible for payment of the claim.

NON–COVERED
SERVICES: Please be aware that some, and perhaps all, of the services you receive may not be covered or deemed
necessary by your Insurance
Provider. You must pay for these services in full if your Insurance
Provider does not cover services. Items such as shoe inserts are not covered by insurance.

PAYMENTS: Payment is
expected at the time of service. Patient/Subscriber responsibility to ensure that their Insurance Provider has
processed the claim and paid for our services. All outstanding balance is due prior to seeing the doctor.

NON–PAYMENT: Accounts Past Due (30 days) are subject to a $35 rebilling fee.
Accounts Past Due (60 days) are referred to a collection service. If your account is forwarded to a collection service and/or an attorney, a fee of 40% of
the balance due will be added to your account to cover collection
cost.

BILLING: Our office uses paperless billing.
A bill will be sent
to your email on file with a phone follow up. If you prefer a paper bill, a $5 processing fee is added to your
bill. If you have a credit card on
file, the balance will be charged to it.

IN OFFICE PRODUCTS: For your convenience, we make some products available for purchase in our office which are not covered by
Insurance Providers. Products include non–custom shoe inserts, surgical shoes, and other products.

NON–TREATMENT RELATED FEES: $20 (minimum)
fees for completion of forms (disability applications, handicap stickers, workman’s comp
etc.). $10 – Detailed receipts of all claims/payments. $10-
Personal copy of patient records. $15
– Copy of x–ray on disc.
Lost prescription scripts/orders $10. Returned checks fee is $50. (FEES SUBJECT TO CHANGE WITHOUT NOTICE)

APPOINTMENT POLICY: A No-Show fee of $100 is charged if you fail to notify our office 24hrs prior to your scheduled appointment time.

* Policy subject to change without notice