FINANCIAL POLICY:
Please review this notice carefully.
It describes our financial policy and the payment for services that you receive through El Paso Integrated Physicians Group, P.A.Thank you for choosing El Paso Integrated Physicians Group as your healthcare provider. It is our goal to become a trusted healthcare partner to you and your family. Our physicians and mid-level medical providers have treated thousands of El Paso residents over many years. We do our best to remain open and accessible to you and to provide the comprehensive diagnostic and medical care you require.
Please understand that payment of your bill is considered part of your treatment. This is a statement of our Financial Policy, which we require you to read and sign prior to any treatment.
Insurance
Your medical insurance policy is a contract between you and your insurance company. We have the expectation that you know and understand your insurance benefits, coverage levels, deductible amounts (if any), copayment amounts, and coverage levels for lab and imaging, and the specialists and hospitals who participate with your insurance plan. You are responsible to know when and if your plan benefits change. El Paso Integrated Physicians Group cannot negotiate for you or change the rules of care we have agreed to with your insurance plan. Not all insurance companies are the same and they do not pay for the same medical services. You are responsible for the full payment if your insurance company reports to you and to us that services are “not covered”.
You are responsible to know when and if your plan benefits change.
We cannot bill your insurance company unless you provide us with your current and valid insurance information and driver’s license. As a courtesy to you we will file your medical claims and let you know when and how much they have paid to us on your behalf. You are responsible for payment-in-full if your insurance company does not pay us within 60 days. You will be sent a statement each month that outlines what you might owe. After 60 days, we ask that you pay the amount on the statement we will send to you.
We need a valid insurance information and driver’s license.
The total cost of your care is due at the time of service in the instance that you hold insurance coverage with a plan with whom we do not participate or if you do not have insurance coverage.
For our patients who have lost their insurance coverage or who do not have medical insurance we offer a 20% discount when you pay for your care at the time of service.
Co-Payments & Deductibles:
All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company.
Missed Appointments:
All co-payments and deductibles must be paid at the time of service.
Unless an appointment is cancelled at least 24 hours in advance, you may be charged for missed appointments at the rate of $40.00 per missed appointment. Please help us to serve you better by keeping scheduled appointments.
Fees for Letters, Forms and Prescriptions:
Your health care provider will be more than happy to fill out any necessary form(s) you may need. Please be advised that due to the time required to complete letters and forms, there will be a $15.00 fee for this service. Please allow us 72 hours to complete the form. These costs are considered non-covered by the insurance companies. For copies of medical records, the fee is $25.00. Please allow 2 weeks to process these requests.
Thank you for understanding our Financial Policy. Please let us know if you have any questions or concerns. I have read the Financial Policy. I understand and agree to this Financial Policy.
Assignment:
I acknowledge that I am assigning directly to El Paso Integrated Physicians Group, P.A. all insurance benefits, if any, otherwise payable to me for services rendered.