Payment Policies / Fees and Payments
Our fees are based upon the reasonable and customary charges prevailing in this area, and take into account the complexity of a particular problem. Fees for a visit or new problem are higher than for a routine follow-up because more time and resources are required to diagnose and treat a new problem than to follow an existing one. If you have questions regarding the fee for a particular problem, please feel free to ask our staff for clarification.
For planned surgery, we will contact your insurance company to verify your benefits and any co-insurance amounts you will owe. A pre-surgical deposit may be required based upon these verified benefits.
The Insurance Company and You
Frequently health insurance companies may pay only part of the physician's fee and services. Certain insurance companies will not reimburse you for soft goods or durable medical equipment (DME) items such as braces or splints. The extent of your benefits is determined by your individual policy. Please keep in mind that services have been rendered to you, the patient, not the insurance company, and you are ultimately responsible for any outstanding balance on your account. We allow thirty (30) days for submission and processing of insurance claims.
We will be glad to assist you with questions regarding claims with your insurance company.
An account balance outstanding more than thirty (30) days is considered delinquent. If unresolved after sixty (60) days, delinquent balances will incur interest at the rate of 1.5% a month and may be turned over to our accounts resolution department for collection.
We currently do accept assignment from Medicare. We current do NOT accept MEDICAL. We do participate with most preferred provider insurance plans. A list of participating plans is provided above. The patient is responsible for any deductible and co-insurance balance.
Workers' compensation claims must be authorized by your employer. At the time of your appointment, be prepared to provide:
If a workers' compensation carrier denies a claim, you will be responsible for charges incurred as a result of the claim. If you have any questions, please speak with our billing office personnel.
Patient Records, Correspondence and Forms Completion
Copies of pertinent medical records are available to the patient or an authorized representative for a nominal fee, after we receive a signed release. Please allow five (5) working days notice. Special documentation requests other than insurance company requirements, such as letters and forms completion, will be honored for a fee. Please speak with our staff for details.
Billing is handled by a well-respected, independent, outside billing service. It deals with the vast majority of reputable insurance companies and plans, including POSs, PPOs, EPOs, as well as Medicare. For more information, call this office first.
El Camino Center for Sports Medicine