Welcome to Bethesda Newtrition and Wellness Solutions. We are pleased that you have chosen us for your healthcare needs. Our mission is to provide you with the highest level of professional healthcare services with the highest degree of patient satisfaction.
To avoid any misunderstanding and ensure timely payment for services, it is important that you understand your financial responsibility with respect to your healthcare. We require that all patients sign our Authorization and Consent For Treatment Form before receiving any services. Please check our website at www.bnws.co to check the insurance plans we participate in and accept assignment.This form confirms that you understand that the services provided are necessary and appropriate, and advises you of your financial responsibility with respect to the services received.
PATIENT RESPONSIBILITY
The Insurance contract is between you (the patient) and the insurance company. It is your responsibility to understand your benefits, deductibles and cost-share as there are many different plans under each insurance company. Patients or their legal representatives are ultimately responsible for all charges incurred for services that are provided. We expect any payments due at the time of your visit for all charges owed for that visit as well as any outstanding balances.We will request full payment for your share prior to the televisit/in person visit on our website at www.bnws.co. If your insurance plan does not provide immediate information regarding patient responsibility, you will be asked to save a credit card on file to settle your account.
The credit card on file will be charged for the balance due when your insurance company notifies us of your patient responsibility. All services for patients who are unable to manage their financial affairs will be billed to the Responsible Party or authorized medical Power of Attorney.
If you can demonstrate financial need and complete the required paperwork, financial assistance may be available. If you have a large balance that you are unable to pay in full, payment plans may be available.
LATE ARRIVALS, CANCELLATIONS AND MISSED APPOINTMENTS
Late Arrivals: If you arrived for a scheduled appointment by 10 minutes or more, you may be asked to reschedule your appointment time on the current day schedule or a future date.
Cancellations/Reschedule/Missed Appointments: If you are unable to keep a scheduled appointment, you must contact our office at least forty eight (48) business hours or two (2) business days in advance to cancel or reschedule an appointment. Failure to contact our office within the specified time line will be considered a missed appointment and charged the applicable fees. The fees are not billed to your insurance company and will be charged to the credit card on file or by patient statement sent to your patient portal.
Fees for Missed Appointments:
New Patient Appointments $100
Routine Physicals/Preventative $100
Annual Wellness Exams $100
Preoperative Exams $100
Initial Medical Nutrition Therapy $100
Transitional Care Visits $100
Psychotherapy Visits $100
All Follow Up Appointments $ 50
As permitted by state law, you may be discharged from the practice following three (3) cancellations or missed appointments in a one (1) year period (365 days).
CREDIT CARD ON FILE PROCESS
The prevailing policy for most service industries requires a credit card to be kept on file to cover the cost of any incidental charges and/or settle balances due. This process benefits both you and the business by making the transaction process easier, faster and more efficient.
Bethesda Newtrition and Wellness Solutions will request patients to provide a credit card when you check in for your appointment or have been contacted by our staff to collect balances due prior to your appointment. All credit card information will be held securely until your insurance company has paid their share and notified us of any additional patient responsibility owed. Charges to the credit card will appear as Bethesda Newtrition and Wellness Solutions. If your credit card is declined or you dispute the charges, you will be assessed a $35 fee. Credit card charges will be processed on the www.bnws.co website and the receipt will be sent to the email on record.
The “Card-On-File” program simplifies payments for the patient and eases the administrative burden on the provider's staff. It additionally reduces paperwork and ultimately helps lower the cost of healthcare. BNWS no longer mails patient statements. Patient Statements will be available via the patient portal or text using our HIPAA compliant service with patient permission only. If your outstanding balance has not been paid after three (3) statements have been sent to you, we will forward your account to the collection agency.
RETURNED CHECKS
Returned Checks to BNWS due to insufficient funds or a closed account will be charged a return check fee of $35. You will also be charged $5 to cover administrative costs to process this notice. Any balances due must be paid by a credit card at www.bnws.co within 10 business days.
MEDICAL INSURANCE
We ask all patients to provide their most current address and proof of identification (Driver’s License) at every visit. If you do not provide current proof of insurance on the day of your visit, you will be billed as an uninsured patient (i.e., self pay) and payment in full will be expected at the time services are rendered. If you provide your insurance card(s) later, we may be able to retroactively bill the services to your insurer depending on the insurance plan requirements. You are expected to pay the entire amount determined by your insurance to be the patient's responsibility. Our fees are for physician, nurse practitioner, dietitian, LCSW, CCM, BHI and RPM services. You may receive additional bills from laboratories, radiology or other diagnostic related services.
You are responsible for Referrals and Authorizations that your insurance plan deems necessary for physician, practitioner and therapy visits. If required and the appropriate referral or authorization are not active, the services will not be provided.
Check with your insurance plan to determine if prescribed testing (lab, radiology) is covered
Check with your insurance plan to determine if prescribed medications are covered. If our providers prescribe a medication that you have not notified us that it is not covered under your plan, you will be required to pay $15 for a new prescription.
Check with your insurance plan to review benefits for applicable deductibles or copayments
Filing appeals with your insurance plan if needed is your responsibility
Coordinating benefits if you have more than one insurance plan. You may be required to contact your insurance company to determine primary coverage and update demographics with our office.
INSURANCE VERIFICATION
We will verify your insurance eligibility two (2) business days prior to your visit. If we are unable to confirm active insurance coverage, we will contact you to confirm insurance eligibility. If you are unable to present an alternative form of active insurance coverage, you will be billed as an uninsured patient and payment in full will be expected at the time services are rendered. For same day appointments, BNWS will confirm eligibility when the appointment is made.
PAYMENTS
Co-Payments: Insurance carriers require that we collect patient co-payments at the time of your visit. If you do make your co-payment, BNWS may cancel your appointment.
Deductibles: Most insurance plans require a yearly “out of pocket” amount before the insurance company will process claims.
Medicare: Beginning January 1 of every year, BNWS will collect the Medicare deductible amounts prior to the visit.
New Patients: $200
Established Patients: $150
Commercial Insurance: BNWS will review On-Line insurance plans to determine applicable deductible amounts to be collected.
Co-Insurance: Some insurance plans require that you pay a percentage of the allowable charge. On-Line insurance plans allow us to view the details of your insurance plans, including your co-insurance amount and calculate the expected out-of-pocket amount due. If we can determine the amount, we will request the co-insurance amount due at the time of your visit.
Out-Of-Network: We participate with some insurance plans. You are expected to contact your insurance company to confirm in-network participation prior to making your appointment. If your insurance requires the selection of a Primary Care Provider (PCP), it is your responsibility to select one of our providers prior to making your appointment.
Non-Covered Services: It is your responsibility to contact your insurance plan to determine covered benefits and services. If a benefit or service is non-covered under your policy, you are expected to pay for the service at the time of your visit.
ABN: If you are a Medicare patient, we are required to inform you of any non-covered services prior to your treatment. Your provider will review the options with you and document the decision and acceptance of financial responsibility using the Medicare (CMS) form CMS-R-131 (03/2020) Advance Beneficiary Notice (ABN).
Prior Authorizations and Prescription Refills: Our providers will fill your prescriptions at the time of visit, so please bring your medication bottles to the visit. Effective March 1, 2023 any prescription refill requested outside of a visit will incur a charge of $15. Any prescriptions provided by our providers that require prior authorization to be completed by your insurance company will incur a charge of $50 per medication payable before the authorization can be completed. Please note we do not complete prior authorizations for medications not ordered by our providers.
After Hours: If you call outside the business hours and want to speak with the provider on call, you will be charged $50. Please note the audio message specifies that by pressing 1 you are accepting the charge of $50 to be connected to the on call provider.
CHRONIC CARE MANAGEMENT (CCM), BEHAVIORAL HEALTH INTEGRATION (BHI) and REMOTE PATIENT MONITORING (RPM)
All patients who have provided consent for CCM, BHI and RPM services will be billed to the primary and secondary insurance companies. These services are billed in those months that time is spent providing those services outside of regularly scheduled visits. Some insurance companies do not include these services as a covered benefit. If the insurance company determines that these services are not covered by the primary or secondary insurer, the patient is responsible for any balances that are due. These services require that a credit card be kept on file to pay for any balances that may be due. If your primary insurance is Medicare and they pay the 80% for the service, we will submit as a courtesy to your secondary but if the secondary insurance does not pay the 20% (Tricare, BCBS FEP, GEHA) then you are responsible to pay the amount.
MOTOR VEHICLE ACCIDENT, WORKERS COMP and DISABILITY
Bethesda Newtrition and Wellness Solutions do not bill personal injury insurance carriers or associated parties. All services related to such cases must be paid at the time services are rendered. Patients are required to inform the front desk staff at the time the appointment is made. Failure to inform staff may result in the termination of the visit and be subject to cancellation fees. BNWS will provide the patient with a statement which can be submitted to the insurance carrier for reimbursement. BNWS does not wait for the outcome of any lawsuits or proceedings to receive payment. I understand BNWS providers and staff do not provide testimony in such legal cases and agree not to request testimony related to these cases.
I have read and understand all the policies outlined in this document. I understand and agree to the patient's responsibility for payment of my account. I understand and agree to the Card-On File program.