Financial Policy

Insurance:

We participate in many insurance plans. For those plans, we will file the forms necessary so that you receive the benefits of your medical coverage. We ask that you read your insurance policy to be fully aware of any limitations of the benefits provided. If you are concerned about coverage for any of our services, please contact your insurance company prior to your visit. If your insurance company denies coverage, or we otherwise do not receive payment 60 days from filing your claim, the amount will then become due and payable by you. Remember that your coverage is a contract between you and your insurance company and/or your employer and your insurance company. Although we will make a good faith effort to assist you in obtaining your benefits, we cannot force your insurance company to pay for the services we have provided to you.

In-Network, Referrals, and Prior-Authorizations

There are thousands of different insurance plans available. A single insurance company may have dozens of different plans. We can provide for you a general idea of whether or not we are contracted with a particular insurance company. However, it is your responsibility to determine if we are in-network with your insurance plan. You are also responsible for knowing if your plan requires a referral from your primary care doctor or a prior-authorization before you receive care at our practice. You are responsible for any charges that are denied by your insurance company due to a network status issue, or failure to obtain a required referral or prior-authorization.

Financial Arrangements:

Because we realize that every person’s financial situation is different, we provide a variety of payment options. For your convenience, we accept all major credit cards (online payment available through the patient portal) and checks. (Returned checks will be subject to a $50 returned check fee). If the check is returned for any reason, you will have 7 days to contact our office and arrange another form of payment.

Late Fees:

Accounts becomes delinquent if not paid within 30 days after billing and the unpaid balance may become subject to a monthly finance charge of 1.5% (18% APR) or $35, whichever is greater. Any further delinquency will warrant the balance and any administrative fees being assigned to a collection agency.

Credit Card on File Policy

PRS requires that all patients provide a credit card on file with our office. We will store your card number is a secure, compliant location in your electronic medical record. For security reasons only the last four digits will be visible to our staff. Credit cards on file will be used to pay copays when you are seen in our office; account balances after your insurance processes your claim and any fees for uncovered services.

Forms Completion and Letter Requests

The completion of forms and the writing of letters are beyond the scope of routine medical care. Requests may incur a charge based on length and complexity. Fee may be waived when completed on the day of an appointment.

Some examples include but are not limited to:

• Handicap Parking Permit Applications                $10

• Letter of Diagnosis                                               $10

• School Forms                                                        $10

• FLMA forms                                                         $20

• Disability Forms                                                   $20

• Guardianship Forms                                             $20

• Attorney Forms and Letters       Hourly Rate Applies

No-Show and Late-Cancelation Fees:

We understand that you may need to cancel or reschedule your appointment. Please let us know by phone, portal message, or text as soon as possible. Failure to notify us at least 24 hours prior to your appointment will result in a charge of $50.

Phone Call Fees

Medical care provided by phone when initiated by the patient may be billed to your insurance company. If you have a copay, coinsurance, or deductible, you may be responsible for some or all of these charges.