Financail policy Essay

Submitted By tm5032
Words: 1289
Pages: 6

Husna R. Baksh, M.D., P.C.
J. Raj Matta PA-C. MPAS, DHSc
Mark Chou, PA-C
10801 Lockwood Dr. Suite 280
Silver Spring, MD 20901
Phone: (301) 593-6072
Fax: (301) 593-6066 www.myhealthysteps.net FINANCIAL POLICY
Welcome to Healthy Steps
Thank you for the trust you have put in us by choosing us as your healthcare provider. We are committed to providing you with the best possible care and to your treatment being successful. Your clear understanding of our financial policy, however, is important to our professional relationship.
Please understand that payment of your bill is considered part of your overall treatment. In order to keep your healthcare costs to an absolute minimum and to allow us to stay open to continue serving you, we have updated our Financial Policy. Please read and sign prior to any treatment.

Making and Keeping Appointments
If you have an outstanding balance of $500 or more, you must pay your balance in full or set up a payment plan within 30 days prior to being scheduled for an appointment. You can be seen for emergency situations within those next 30 days.
Initials _____
If you need to cancel or reschedule your appointment, we require a 24 hour advance notice in order to avoid our no show/cancellation fee. We have a high demand for appointments so keeping appointments and being on time is a critical factor for keeping our providers running on time. Not receiving the reminder call is not a valid reason for not coming to your appointment since this is a courtesy call to you. If you are 10 minutes late (or more), you have lost your appointment slot. If our schedule allows, we will add you to the day’s schedule as an add-on or schedule you for a later appointment slot. If you cannot be added to the schedule, you will receive one of the charges below.
Fees: $50 for appointments Monday – Friday
$100 for appointments on Saturday
This policy is necessary to allow us to accommodate patients who need to be seen emergently as well as hold our patients accountable for appointments made. Excessive no shows may results in a charge being added to your account and you may also be dismissed from the practice.

Fees and Payments
Fees are standardized and are based on the complexity of your visit or procedures done. Payment of copayment and any outstanding balance is required at the time of service. We accept cash, personal check, Visa, American Express, or MasterCard. While the filing of insurance claims is a courtesy that we extend our patients, all charges are your responsibility from the date that services are rendered. In order for us to file a claim, you must present a current copy of your insurance card at each visit and communicate any changes in your personal contact information.
Initials _____
Most insurances policies specify that some of the cost of the patient’s care is the patient’s responsibility. This can be accomplished through any combination of co-payments, coinsurance, or deductibles. Co-payments are due when you check in for your appointment. Coinsurance and deductibles are determined by your insurance company and reported to us on your explanation of benefits. Once we are notified, we will add the appropriate charge to your account and send you a

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Husna R. Baksh, M.D., P.C.
J. Raj Matta PA-C. MPAS, DHSc
Mark Chou, PA-C
10801 Lockwood Dr. Suite 280
Silver Spring, MD 20901
Phone: (301) 593-6072
Fax: (301) 593-6066 www.myhealthysteps.net statement. This charge is payable upon receipt of the statement. Once payments are received, they will be automatically applied to a specific charge.

Insurance Plans
Your insurance coverage is a contract between you, your employer, and the insurance company; we are not a party to that contract. We must emphasize that as healthcare providers, our relationship is with you, not with your insurance company. Before your visit, please contact your insurance company to verify that the physician that you are scheduled with participates with your plan and that the…