Thank you for choosing Gentle Foot Care Clinic for your podiatric care. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy. Please read it, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.
Insurance. We participate in most insurance plans. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage. Patient's are responsible for all out of pocket expenses such as deductible, copayments, coinsurances and non covered items and we collect in full prior to the services being rendered.
Co-payments and 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. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment, coinsurance and deductible at each visit.
Non-covered services. Please be aware that some – and perhaps all – of the services you receive may be noncovered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services in full at the time of visit.
Proof of insurance. All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.
Nonpayment. If your account is over 60-90 days past due, you will receive a letter stating that you have 15 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated with our billing staff. Please be aware that if a balance remains unpaid after 2 statements (60-90 days), we will then send a "final notice statement" and you have 15 days to pay in full or we will refer your account to our collection agency. Your account will be charged a 30% collection fee which will be added to your existing balance and you will be required to pay in full prior to any further appointments being offered.
Missed appointments. Our policy is to charge a $25 fee for missed appointments not canceled within a 24 hour time from of the scheduled appointment. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment.
Over the counter purchases and Durable Medical Equipment (DME) items: our office sells items that are considered over the counter and are not payable by insurance companies. Any DME item dispensed may or may not be covered by your insurance company. Most insurance companies DO NOT pay for custom orthotics since it may not be considered medically necessary; therefore we require payment in full up front prior to making the orthotics. Any Medicare Patient receiving a DME item must inform our office if they've received the same or similar item within the past three years since Medicare DME only allows for one foot item every three years.
Please note, it is your responsibility prior to making an appointment, to contact your insurance company to confirm that we are a participating provider and/or participating group under your insurance network. We are NOT on all insurance plans and if you have an HMO, you must verbally inform our front desk prior to treatment. I understand that Gentle Foot Care Clinic does not participate in many HMO's and that I may be responsible for payment in full. If you are on an insurance plan that requires prior authorization and/or a referral for your visits, it it your responsibility to obtain all necessary documents or authorization numbers or you will be liable for payment due to lack of prior approval.
Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area.
Thank you for understanding our payment policy. Please let us know if you have any questions or concerns.