Financial Policy and Patient's Financial Responsibilities
We have adopted the following financial policy to avoid any misunderstanding between our patients and this office.
We are dedicated to providing the best possible care and service to you and regard your complete understanding of your financial responsibilities as an essential element of your care and treatment.
You are expected to know your own coverage for services rendered since it is impossible to keep track of every insurance plan and how it works. Contact your insurance company referencing benefits before beginning treatment.
FULL PAYMENT IS DUE AT TIME OF SERVICE unless other arrangements have been made in advance by you or your health coverage carrier. Unpaid and past due balances are subject to a finance charge of 18% (Annual Percentage Rate) and additional collection service fees.
We now offer 12 months Interest-Free payment plans via CareCredit.
No Insurance: We require payment at the time of service if you do not have insurance coverage for services rendered. Contact our Business Manager to arrange payment options.
Insurance: We process all insurance claims on behalf of our patients. Patient identification, insurance information and a copy of your insurance card must be provided prior to your first visit. Assignment of benefits is required with commercial insurance. Failure to provide complete information will result in account being billed directly to the patient.
Co-Payments & Referrals: Co-payments required by your insurance plan are collected at time of service. You are responsible for verifying if an insurance referral from your primary physician is required at the time they process your claim. You agree to be held responsible for any charges not covered by your insurance if you choose to be seen without the appropriate referral.
Deductibles: Pre-payments are required in the event you have not met your deductible. Any credit amount after your claim has been submitted and adjudicated by your insurance carrier will be credited towards your account or refunded upon written request.
Medicare: We accept assignment of benefits from Medicare. We collect 20% of the Medicare allowable of the charges for your visit if you do not have a secondary insurance to your Medicare.
COBRA Insurance: You are responsible to provide all COBRA insurance information and to notify the billing office when your COBRA is activated to avoid denial of your claims by your insurance.
Non-Covered Services: You will be responsible for the entire charge(s) if your medical plan determines a service is “not covered”.
Statements Due upon Receipt: Full payment is immediately due upon receipt of statement. Late payments are subject to finance charges and collection service fees.
Minor Patients: The adult accompanying the patient and the parent or guardian with custody will be billed for all services rendered to minor patients.
Missed Appointments (No Shows): In order to provide the best service and availability to our patients, it is your responsibility to notify us 24 hours in advance that you will be unable to keep your appointment. Missed appointments are subject to a “no show” fee of $75.00 per incident. Suncoast Women's Care reserves the right to discharge you from our practice for non-compliance.
We are dedicated to providing the best possible care and service to you and regard your complete understanding of your financial responsibilities as an essential element of your care and treatment.
You are expected to know your own coverage for services rendered since it is impossible to keep track of every insurance plan and how it works. Contact your insurance company referencing benefits before beginning treatment.
FULL PAYMENT IS DUE AT TIME OF SERVICE unless other arrangements have been made in advance by you or your health coverage carrier. Unpaid and past due balances are subject to a finance charge of 18% (Annual Percentage Rate) and additional collection service fees.
We now offer 12 months Interest-Free payment plans via CareCredit.
No Insurance: We require payment at the time of service if you do not have insurance coverage for services rendered. Contact our Business Manager to arrange payment options.
Insurance: We process all insurance claims on behalf of our patients. Patient identification, insurance information and a copy of your insurance card must be provided prior to your first visit. Assignment of benefits is required with commercial insurance. Failure to provide complete information will result in account being billed directly to the patient.
Co-Payments & Referrals: Co-payments required by your insurance plan are collected at time of service. You are responsible for verifying if an insurance referral from your primary physician is required at the time they process your claim. You agree to be held responsible for any charges not covered by your insurance if you choose to be seen without the appropriate referral.
Deductibles: Pre-payments are required in the event you have not met your deductible. Any credit amount after your claim has been submitted and adjudicated by your insurance carrier will be credited towards your account or refunded upon written request.
Medicare: We accept assignment of benefits from Medicare. We collect 20% of the Medicare allowable of the charges for your visit if you do not have a secondary insurance to your Medicare.
COBRA Insurance: You are responsible to provide all COBRA insurance information and to notify the billing office when your COBRA is activated to avoid denial of your claims by your insurance.
Non-Covered Services: You will be responsible for the entire charge(s) if your medical plan determines a service is “not covered”.
Statements Due upon Receipt: Full payment is immediately due upon receipt of statement. Late payments are subject to finance charges and collection service fees.
Minor Patients: The adult accompanying the patient and the parent or guardian with custody will be billed for all services rendered to minor patients.
Missed Appointments (No Shows): In order to provide the best service and availability to our patients, it is your responsibility to notify us 24 hours in advance that you will be unable to keep your appointment. Missed appointments are subject to a “no show” fee of $75.00 per incident. Suncoast Women's Care reserves the right to discharge you from our practice for non-compliance.
