Thank you for choosing Greater Ohio Eye Surgeons (GOES) to serve your medical and surgical eye care needs. We are pleased to participate in your health care and look forward to establishing a lasting relationship with you. As part of this relationship, we want you to understand the process of billing and receiving payment for services and your responsibilities. Please read this policy carefully.
Payment in full is required at the time of your visit. This may include past due amounts, deductibles and insurance copayments or coinsurance. Payment may be made with cash, personal check, money-order, Visa, MasterCard, Discover and American Express.
While filing insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date services are rendered. Your insurance is a contract between you, the insurance company and/or your employer. We are not party to that contract.
Before your visit, please contact your insurance company to verify that your GOES physician is a participant in your plan, and the services you intend to receive are covered. In order for us to file a claim, you must present a current copy of your insurance card at each visit and communicate any changes in your personal information.
Not all services are a covered benefit in all policies, so it is very important that you understand the provisions of your individual policy. Insurance companies select certain services they will not pay for. Therefore, we cannot guarantee payment of all claims by your insurance company. Reduction or rejection of your claim does not relieve you of your financial responsibility.
Address Change
It is important that we have your correct address information on file. Please advise us anytime there are any changes to your address, telephone or other contact information.
Billing
If your insurance company determines you owe additional money after your visit, you will receive a statement. Statements are mailed out on a weekly basis. Payment is expected within 15 days of receipt of your statement.
Copayments, Deductibles, and Coinsurance
Copayments are collected at time of service. Your insurance company requires us to collect copayments from you at time of service at every visit.
Insurance deductibles and fees for services not covered by your insurance policy, if known, are due at time of service. We accept cash, check and most major credit cards.
Failure to Pay
Patients who do not respond to their statement will receive a collection letter. Failure to respond to the collection letter and pay your balance or arrange a payment plan will result in your account being submitted to an outside collection agency
Past due accounts may hinder your ability to schedule future appointments and may result in being dismissed from the practice.
Should your account balance become uncollectible, or you file bankruptcy, we will continue to see you on an emergency basis for 30 days, giving you time to find a new ophthalmologist.
Fees
A $15.00 charge will be added to your account if you fail to pay your copay at time of service. Additionally, your copay will be collected at time of check-in for all future appointments. If you arrive without your copay, we may ask you to reschedule your appointment.
Returned checks are subject to a bank fee of $15.00 and your account will be placed in a “cash only status.” We will accept payments by cash or credit card only until the balance is cleared.
We reserve the right to charge a fee for canceled or missed appointments. Missed appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. We require a minimum of 24 hour notice if you must cancel your appointment.
Insurance
It is important for you to be an informed consumer who understands your insurance coverage insurance coverage and any additional requirements for obtaining care from a specialist’s office. Your insurance may require a referral or authorization from your primary care specialist to be seen by our physicians. We are not considered a participating provider for the purpose of annual well eye exams. Your health insurance policy is a contract between you and your insurance company or employer. Please note, it is your responsibility to know if your insurance has specific rules or regulations, such as the need for referrals, pre-certifications, and care being provided by a “participating list of physicians.” This information can be obtained by contacting your insurance carrier.
You must present a current insurance card and valid photo ID at each visit. As a courtesy to you, we will bill your insurance company directly for medical services rendered. If problems arise regarding coverage issues, we will attempt to work with your insurance company to help resolve the issues prior to making it your responsibility. However, please be advised that you are ultimately financially responsible for the payment of medical services rendered.
If you do not present a current insurance card, you will be responsible for payment at time of service. You may receive reimbursement from GOES if your insurance pays the claim at a later date.
If we contact your insurance carrier regarding benefits or authorization on your behalf, we are not responsible for inaccurate information provided to us by your carrier. Any information about your plan that we communicate to your is in good faith.
Medicare
Our physicians do accept Medicare assignment or the Medicare approved amount as full payment for covered services. You are responsible for paying the Medicare deductible and coinsurance amount, as determined by Medicare.
Minors and Dependents
The legal guardian must be present to make treatment decisions at the time of the appointment or a Permission to Treat a Minor form and/or a Permission to Accompany a Minor form must be signed prior to the appointment.
Parents and guardians are responsible for payment for services rendered.
Referrals and Authorizations
Please be aware of and provide any required referrals or authorizations in advance of your appointment. If you do not obtain the required referrals or authorizations, you will be responsible for the cost of your care. Please contact your insurance carrier directly for any clarification.
Refunds
A refund will be issued when an overpayment has been identified and there are no other patient responsible balances. If you feel that a refund is due, please contact our billing office.
Self-Pay Patients
All cash patients and patients present without valid insurance information are considered self- pay patients. Self-pay patients should be prepared to pay at the time of each visit.
A down payment of at least 50% of the estimated physician fees must be paid before we will schedule surgery. Payment must be completed on or before the date of surgery.
Workers Compensation
If you require medical attention due to an injury while on the job, you must notify us at the time of your visit so the appropriate paperwork is filed and authorization is received for your treatment. We cannot “go back” and file this paperwork after your visit.
If you already have filed a claim, you are responsible for providing a claim number, name of payer, date of injury, employer at time of injury and the name and number of the claim adjuster. Without this information, you will be responsible for all charges and payment must be made at time of service.