There are numerous insurance networks in the Peoria market.  Our physicians are not a part of all of these networks; therefore, they have not agreed to accept a reduced fee from all insurance companies.  Many insurance companies pay a different percentage of charges based on whether or not the physician is a part of the network.  It is the responsibility of the patient to know and understand the benefits of their insurance plan.

Insurance coverage is a contract between the patient and the insurance carrier; however, the office will assist in every way in order to maximize your insurance benefits.  The patient will be responsible for any deductible, coinsurance, copay, and non-covered benefits according to the insurance plan. If an insurance problem occurs, the patient may be asked to assist the office in contacting the carrier and/or in filing a complaint with the State Insurance Commissioner.

The following information is the office policy concerning payment for professional services:

1. If the provider is not contracted with an insurance plan network, the patient will be required to remit full payment at the time of the office visit.
2. All patients will be required to establish financial arrangements for payment of their account.
3. According to each contract that we have with an insurance company, we are required to collect the co-payment at the time of service, as well as payment of deductible and co-insurance upon receipt of Explanation of Benefits. Requests made from patients to write off patient responsibility charges such as copays, coinsurance, and deductibles, will not be tolerated and may result in dismissal from the practice.
4. Clinical office visit charges only cover the cost of the appointment with the physician, mid-level provider, or nurse (or combination thereof) on the day of your appointment.  This charge does not cover any additional diagnostic testing, scopes, CT scans, lab, audiological and allergy testing or supplies, or any other tests or procedures that may be appropriate before, during, or after the visit with a medical provider.  The insurance company may or may not cover some or all the costs of these additional tests or services and the patient has the right to accept or refuse any of these services prior to.  However, refusing these could limit the medical provider’s ability to properly diagnose and treat the medical condition and may limit their ability to provide an appropriate surgical treatment or solution.
5. If an insurance company has not settled a clean claim within 60 days, the patient may be notified and be responsible for the balance. If a patient presents invalid insurance, the patient will be responsible for the balance unless valid insurance is provided.
6. Each month, patients will receive a statement for services which is due and payable by the payment due date on the statement. If payment is late, or if the patient has not previously made financial arrangements, a second invoice will be mailed stating that the account is in review and to please call our office.
7. Accounts that have an outstanding balance for over 90 days may be sent to an outside collection agency.  If an account is sent to the collection agency, additional service fees will be added by the agency and the account must be settled through them.
8. Any questions concerning the office financial policy or a patient’s need for assistance should be immediately directed to the billing department or practice administration.