Financial Policy

AOC is committed to providing you with the best possible care and can discuss our professional fees with you at any time. It is important to our patient-physician relationship that you read and fully understand our financial policy. Please let us know if you have any questions about your financial responsibility.

 

New patients are required to complete patient registration documents and medical history forms via an electronic registration tablet prior to seeing the physician. Established patients are required to update their information forms at least once a year via the same electronic registration tablet. We will ask to see your insurance card and driver’s license on every visit and will scan your card into our system as needed to keep our information current. Patients are required to pay Copayments/Deductibles upon arrival to their visit. You can make your payment to the Front Office Receptionists with cash or check or by Credit Card on the tablet you are provided at check-in.

 

COPAYMENT/DEDUCTIBLE

Your insurance requires that we collect your designated co-pay and/or deductible at the time of service. Please be prepared to pay the above fees at each visit.

 

PRIVATE PAY

Private pay accounts shall exist if a patient has no insurance coverage. For new patients, a payment of $250 – $500, dependent upon the anatomical site, is expected on the day of your appointment before treatment from your physician. Established patients will be required to make, and keep current, all payment arrangements specified in their individual payment plan.

 

EXTENDED PAYMENT PLANS

Patients are encouraged to pay outstanding private-pay balances in full. However, payment plans may be accepted with the approval of the business office manager.

 

OUT-OF-NETWORK INSURANCE PLANS

As a service to our patients, we will bill as a non-assigned claim. Any outstanding balances are the responsibility of the patient. We are in-network for most, but not all insurance plans, it is your responsibility to verify what your insurance plan will cover and that we are providers for your plan.

 

REFERRALS

If your Insurance Plan (Primary or Secondary) requires a referral from your Primary Care Physician it is YOUR responsibility to obtain it prior to your appointment and to have it with you at the time of the appointment. If you do not have your referral, you may be required to reschedule.

 

WORKERS’ COMPENSATION

If you are seeing a physician as a result of a work-related injury, please have your employer contact our Workers Compensation department to schedule your appointment.

 

MEDICARE

We will submit to Medicare for the Medicare allowed amount. The patient will be responsible for the deductible and the co-insurance, which can be billed to secondary insurance if applicable.

 

RETURNED CHECK FEES

Any returned check from the bank for non-payment (insufficient funds) shall result in the patient’s account being assessed a $35 fee per check returned.

 

DELINQUENT ACCOUNTS

Delinquent accounts may be assigned to a collection agency. All collection costs will be added to your outstanding balance.

 

PARENTAL CONSENT

We cannot be involved in negotiating payment for divorce orders for medical bills. Whichever parent brings the minor child in for treatment will be responsible for payment of the bill.

 

FORMS COMPLETION/MEDICAL RECORDS REQUESTS

From time to time various forms including but not limited to disability and FMLA forms will need to be filled out. There will be a $26.50 charge to complete these forms. There is a nominal fee for copying medical records in accordance with the state allowance.

 

We accept cash, MasterCard, Visa, Discover, American Express, debit cards, and checks.  Online payments can be made here. We do have a check scanning system to process and verify all checks.

 

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