Thank you for allowing us the privilege of providing your care. The following is a statement of our financial policy. We require you to read and sign prior to any medical services being rendered. This policy will be updated yearly.
- Your specialist co-pay is expected in full at the time of service.
- You will be asked to show your current insurance card(s) and photo ID at every visit.
- New patients who do not present a current insurance card at check in will be asked to pay in full at the initial visit.
- Full payment is due at the time of service unless we have a contract with your insurance company. We accept cash, checks, Visa, MasterCard, American Express, and Discover.
- Please note, returned checks are subject to a $30.00 service fee.
- If you pay in cash the office does not carry change.
- If you have an insurance plan that requires a referral, you will need to present a printed copy of the referral at check in. If you do not have your referral, you will be asked to sign a waiver accepting full responsibility for any changes related to services provided on that date.
- You will be notified of all balances unpaid by your insurance. Regardless of insurance coverage, you are responsible for all bills being paid in a timely manner. All unpaid balances will be sent to collections 90 days from receipt of the explanation of benefits. Raleigh Endocrine Associates reserves the right at any time to suspend appointments, or refer you for care elsewhere for non-payment.
Please be aware that some services provided at Raleigh Endocrine Associates may be deemed non-covered services or not medically necessary under Medicare and/or other medical insurance programs. Due to the number of new plans available and the constant changes in insurance carrier policies, Raleigh Endocrine Associates will not guarantee insurance coverage or payment for any services. Patients are responsible for understanding their own coverage, co-pays, co-insurance, deductibles, and any referral or pre-authorization requirements.
SELF PAY AND NON-PARTICIPATING INSURANCE:
- All patients without insurance will be provided with an estimate of charges on the day of their visit.
- All self-pay charges paid in full at time of service are eligible for a 35% Prompt Pay Discount, any unpaid charges must be set up on an approved payment plan
- Non-contracted insurance plans are considered non-participating and will be processed as out-of-network. All charges will be subject to all applicable co-pay, co-insurance, deductible, and out-of-network benefits, if any.
- All claims will be filed as a courtesy to all insurance companies when presented with a current and valid insurance card
NO SHOW, SAME DAY CANCELLATION, AND LATE ARRIVAL POLICY:
Our goal is to provide excellent care to each patient in a timely manner. If it is necessary to cancel an appointment, patients are required to call or leave a message at least 24 hours before their appointment time. Notification allows the practice to better utilize appointments for other patients in need of prompt medical care.
The fee for a “no show” or “same day cancellation” will be $100.00 for new patient appointments and re-consultations, and $75.00 for follow-up visits. All fees must be paid prior to any rescheduling.
- A “no-show” means any patient who fails to arrive for a scheduled appointment.
- A “same-day cancellation” means any patient who cancels an appointment less than 24 hours before their scheduled appointment.
- Monday appointments must be cancelled by noon the preceding Friday to avoid the “same day cancellation” fee.
As a courtesy, we attempt to contact every patient with an appointment reminder phone call, e-mail, and /or text message. However, it is the responsibility of the patient to arrive on time. If you arrive late for your appointment, you may be asked to reschedule. Due to the inability to fill the missed appointment slot and the corresponding cost associated with an open slot, a $75.00 fee will be charged.
- A “late arrival” means any patient who arrives more than ten (10) minutes after the scheduled appointment time.
All fees must be paid prior to any rescheduling.
MEDICAL RECORDS & PHYSICIAN FORMS:
In the State of North Carolina, a health care provider may charge a reasonable fee to cover the cost incurred in searching, handling, copying, and/or mailing medical records to the patient or the patient’s designated representative.
The fee for each request shall be seventy-five cents (.75) per page for the first 25 pages, fifty cents (.50) per page for pages 26 through 100, and twenty-five cents (.25) for each page in excess of 100 pages, in compliance with NC Statute. To submit a request, the patient or the authorized representative must complete and sign the proper request form. To obtain a copy of this form please visit our website at raleighendocrine.com.
Medical forms that require physician completion, signatures, and specially requested letters are subject to a fee of $20.00 to $60.00.
Our physician on-call is available to you after hours by calling our main office number at 919-876-7692. Should you need to contact the physician on-call, this may result in additional charges which are not covered by insurance. These charges typically bill at $30-$60 per call, based on length and complexity. Unfortunately, we are not able to handle new prescription or medication refill requests after office hours. If you have a medical emergency, we recommend that you visit your nearest hospital emergency department.
For billing inquiries related to dates of service October 8,2019 and after, please call 1-855-214-3969.
Thank you for understanding the necessity of our financial policy. Please let us know if you have any questions or concerns regarding the above financial policy.