Office contracts are the same as Endoscopy Center contracts with exceptions as follows:
- Beech Street (Office only)
- Champ VA
- First Health (Office Only)
- Medicaid (No HMO Plans)
- Medical Mutual
- AARP Medicare
- Secure Care Hometown
- United Healthcare Complete
- Miscellaneous Medicare Advantage Plans
- Medicare Railroad
- Ohio Health Choice Plan
- Primary Health Service (PHS)
- THP (The Health Plan aka Hometown)
- Tricare For Life
- United Healthcare
- United Mineworkers
Payment of statement balance within 20 days from statement date is expected.
We realize that temporary financial problems affect timely payment of your account. Whenever treatment is extensive, payment may be extended over a mutually agreeable period of time, usually three months with a written arrangement in order to conform to the Federal Truth in Lending Law. Our Patient Accounts Department can assist you with any questions you may have.
There will be a fee for completion of each form. Your form must be accompanied by a stamped envelope, addressed to your insurance company or employer, and the fee for completion of these forms must be paid in advance.
There will be a charge for a copy of your records.
There will be a $35.00 charge for checks returned for insufficient funds.
Unless a 48-hour notice is given, you may be charged for broken appointments. This charge will be $50.00 for a broken office visit and $150.00 for procedure appointments.
It is almost inevitable that insurance and account questions will arise. We encourage you to contact us promptly for assistance in the management of your account. If you have any questions about the above information or any uncertainty regarding insurance coverage, PLEASE do not hesitate to call us at (330) 455-5011 ext. 108.
For Patients With Medical Insurance
- Your insurance is a contract between you or your employer and the insurance company. We are not a party to that contract.
- We participate in a number of insurance plans. Please check with your insurance carrier to confirm whether or not we are on your particular plan.
- Our fees are generally considered to fall within the acceptable range by most insurance companies. These fees are defined as usual, customary and reasonable (UCR) and are covered up to the maximum allowed amount, a percentage determined by each insurance company. NOTE: This statement does not apply to companies who reimburse based on an arbitrary “schedule” of fees, which bears no relationship to the current standard and cost of care in this area.
- Not all services are a covered benefit in all contracts. Some insurance companies arbitrarily select certain services they will not cover. We must emphasize that as medical care providers our relationship is with you, not your insurance company.
- We are here to assist you in receiving your maximum allowed benefits. We file both primary and secondary insurance claims at no charge. WE MUST HAVE YOUR INSURANCE COMPANY’S ADDRESS, YOUR ID NUMBER AND GROUP NUMBER. PLEASE BRING THIS INFORMATION WITH YOU EVERY VISIT. Your designated copay and/or deductible is required at the time service is rendered. Payment may be made by cash, check, money order, MasterCard, VISA, Discover or American Express.
For Patients Without Medical Insurance
- To establish credit with us, payment in full is expected for all charges incurred at the time of the initial visit. Payment may be made by cash, check, money order, MasterCard, VISA, Discover or American Express.
- Should any other charges be incurred and payments need to be set up, please contact Patient Accounts at (330) 588-5451 .