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Payment Policies

Thank you for choosing ProMedica Physicians. We make every effort to provide our patients with accurate, timely processing of bills and insurance claims.

If you have questions regarding your bill or claim, please call 419-824-7250 or 1-800-936-7250. Please remember that specific questions regarding your individual insurance coverage, deductible, copay and referral network can only be answered by your insurance company or employer.

Please note: We are currently updating our billing system. You may receive two statements for your account. These are not duplicate bills, and both are due and payable upon receipt. Thank you for your patience!

The following financial guidelines should help expedite the payment of your bill or claim.

Payment Options
ProMedica Physicians accepts cash, checks, Visa, MasterCard and Discover.

Insurance Billing Process
It is the patient’s responsibility to bring a current insurance card to every appointment. As a courtesy to our patients, ProMedica Physicians submits claims to primary and secondary insurance carriers. Any balance not payable by insurance is considered the patient’s responsibility. A statement reflecting that balance will be sent to patients in the mail. At that time, the full payment is due.

All copayment amounts are due and payable at the time of every appointment. Please be prepared to pay any outstanding balance at your next visit or when you receive your statement.

Patients may also be charged a “no show” fee if they fail to cancel at least two hours prior to their scheduled appointment time.

Medicare Guidelines
For patients eligible for Medicare, ProMedica Physicians is considered “participating physicians.” That means we will submit claims to Medicare on your behalf. Medicare will send a check to ProMedica Physicians for 80% of the approved amount, minus the patient’s Part B deductible.

Therefore, patients are responsible for the remaining 20% of the approved amount, plus the annual Part B deductible. Additionally, patients are responsible for any portion of the bill not covered by Medicare or a secondary insurance carrier. If you have supplemental insurance coverage, please make certain we have a copy of your insurance card.

Guarantor Policy for Dependent Children
The responsibility for payments rests with the parent or guardian who brings the dependent child to the initial office visit and signs the authorization for treatment (“authorizing parent/guardian”). Payment for subsequent visits is the responsibility of the authorizing parent/guardian, regardless of who brings the child into the physician’s office. This applies to cases of divorce, annulment, dissolution of marriage or legal separation. However, ProMedica Physicians offices are not impacted by court orders or judgments. Any issues that arise regarding payment must be resolved by the parents or guardians and the court system.

Patients 18 years of age or older are considered the guarantor regardless of who carries the insurance.

Workers’ Compensation
Workers’ compensation claims are considered to be the patient’s responsibility until a valid workers’ compensation number is obtained from the patient’s employer.

Auto Accident
Auto accident claims are billed to the patient’s medical insurance. The patient is responsible for any copay, co-insurance or deductible. If the insurance company denies the claim, the patient will be responsible.

Obstetrical Payment Plan
All deductibles, copayments or patient balances are to be collected in full by the patient’s 28th week of pregnancy. Monthly payments may be arranged with the office staff to satisfy this financial responsibility.

Financial and Medical Assistance Programs
You may be eligible for assistance if you are not eligible for Medicaid, do not have health insurance or any other form of third-party payment for your health care, and your family income is below 200% of the federal poverty guidelines. If you think you meet these requirements, please contact a ProMedica Physicians financial counselor at 419-824-7250 or 1-800-936-7250, 8 a.m. – 5 p.m., Monday – Friday. Proof of family income is required.

For More Information
We hope these financial guidelines have helped you better understand a patient’s rights and responsibilities. If you have any questions or need clarification, please feel free to contact ProMedica Physicians at 419-824-7250 or 1-800-936-7250, 8 a.m. – 5 p.m., Monday – Friday.

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