Welcome to Anderson Oral and Maxillofacial Surgery, P.S.C. We want to thank you for choosing us as your healthcare provider. In an effort to provide the best care possible, we would like to take a moment and explain a few of our policies.
Please bring a picture ID and your insurance card to each visit-this is to protect yourself and our practice from identity theft. Please be sure we have the most current demographic and insurance information at all times. You will be asked to sign in with your name, address, phone number, and insurance name at each visit, as well as complete a new demographic sheet on a yearly basis. Filing claims with incorrect information delays processing and increases patient liability. Please note if you fail to give us updated insurance information at the time of your appointment, we will not be able to file your claim to the correct company after 30 days from the date of your visit.
We understand that your time is valuable and we do our best at keeping the schedule running smoothly and on time. Out of respect for all patients we ask that you be on time for each appointment. Any patient who arrives greater than 20 minutes past their scheduled appointment time may be asked to reschedule for a different day.
Should an emergency arise, we ask that you be patient as we do our best to handle the situation and return to seeing patients as scheduled. Unfortunately, it may be necessary for us to reschedule appointments unexpectedly, should this occur we will do our best to notify you as soon as possible and reschedule you at the next earliest time.
Should you need to cancel or reschedule an appointment, please contact the office as soon as possible; 48 hours’ notice is appreciated. Failure to notify the office prior to your scheduled appointment 3 times could result in you being dismissed from the practice.
We recommend that you contact your insurance carrier prior to each visit and inquire about the type of benefits you have. The more familiar you are with your benefits the less likely you will have unexpected financial responsibility. Payment is due at the time of service, according to your current insurance benefits, this could include copays, deductibles, and co-insurance amounts.
A non-covered service is any service that is denied by your insurance carrier due to benefit descriptions or limitations, policy exclusions, or pre-existing waiting periods. Non-covered services will be the responsibility of the patient and payment is due at the time of service. Please contact your insurance carrier and inquire about any service that may be non-covered. If you receive a service that is considered non-covered by your insurance plan, you will be expected to make payment in full for all charges.
We are contracted with multiple insurance companies. Some insurance companies have special programs that allow for better benefits for you as the patient. While Dr. Anderson may be contracted with the insurance company in general, they may not be a preferred provider under these special programs. We suggest you always verify with your insurance carrier to confirm there is nothing specific about your plan that would exclude our practice.
Our office attempts to verify all patient’s insurance benefits prior to their appointment. Any copay, deductible, or co-insurance is due at time of service. We will give you the best estimate possible based off of the benefits quoted. Please keep in mind, sometimes benefits are misquoted by your insurance carrier; however we must collect based off their explanation. Once your insurance carrier has finalized your claim, we will make any necessary adjustments to your account.
Note- While we attempt to be as accurate as we can when verifying your benefits; ultimately knowing your insurance plan and how it pays is your responsibility. We are happy to provide you with information to help you verify your own insurance more accurately. Please feel free to call our billing department with questions. All outstanding balances are due in full upon receipt of statement.
While we are not obligated to file claims for you with all contracted insurance companies, we are happy to do so as a courtesy to our patients. We will be happy to file your claims to non-contracted companies. Secondary insurance plans can be of great assistance in the payment process. We will file deductible and co-insurance amounts to any secondary insurance you provide us; co-payments will not be filed to your secondary. If you have multiple insurance carriers, please make sure each carrier is aware of the other and you provide us with accurate information. An insurance carrier in the patient’s name is always primary; you may not choose which carrier to use as primary vs. secondary.
Insurance Billing and Payment
In an effort to reduce patient financial liability, it is sometimes necessary for our billing department to appeal claims. In doing so, it may also be necessary to involve other agencies such as the Kentucky Department of Insurance. By signing this policy, you agree to allow us to release certain demographical, dental and medical information to these agencies in order to secure payment. Please be assured we will only release information that is absolutely necessary.
Should your insurance company require a referral or authorization, it is your responsibility to obtain or request one prior to your appointment. Please note some insurance carriers will not allow us to issue a referral, you may be required to go through your PCP.
The patient will be considered as the responsible party for payment purposes. If the patient is under the age of 18 the parent/guardian authorizing care will be responsible for payment of service, at time of service. They will also need to be present at the minor patient’s appointment. If a patient is over 18, regardless of who holds the insurance policy, the patient will be responsible for payment of services.
Should your insurance process your claim differently than quoted or expected, any refund due to you will be issued.
Payment is accepted in the form of cash, check, money order, or credit card. Should a payment be returned for any reason, including but not limited to, insufficient funds, stop payment, or closed account, the patient will be liable for the original amount plus any associated NSF fees. Our current NSF fee is $35.00.
I have read, understand, and agree to the information and policies set forth in this agreement. I further agree that a photocopy of this agreement or an electronic signature is as valid as an original.