|
INSURANCE GUIDLINES
|
|
General Insurance Guidlines
Prior to seeing one of our physicians, we recommend that you contact your insurance provider regarding coverage of services. Because there are so many variations with insurance plans, knowing your coverage will help ensure that you are not left responsible for large out-of-pocket expenses. The Heart Institute of Northwest Ohio physicians are contracted with many Insurances and Medicare. If you have a concern about your physician being a provider on your insurance plan please call your insurance company or visit their web site for an accurate list of approved providers. Please remember. The professional services rendered by the Heart Institute of Northwest Ohio are charged to the PATIENT and NOT THE INSURANCE COMPANY. Medical Insurance: To accomodate the needs of our patients, we have enrolled in numerous managed care insurance programs. While we are please to be able to provide this service to you, it is very difficult for us to keep track of all individual requirements of the plans. If your insurance company requires you to have a referral from your primary care physisican in order to be treated, please let us know that you have taken care of this. We work diligently to provide services as a convenience to our patients, however, ultimately, the responsibility for adherance to to the guidelines of your individual insurance plan are your responsibility. In the event insurance does not cover your treatment for any reason, payment is your responsibility for the date of service, and all cooresponding and related charges. Our billing staff will submit a claim directly to your insurance company provided we have accurate insurance information. Failure to obtain pre-certification or prior authorization may result in decreased benefits to you by your insurance company. Medicare: The Heart Institute of Northwest Ohio is a participating provider in the Medicare Assignment program. We would like to make this process as easy for the patient as possible. We will bill Medicare for your charges. In most cases, Medicare will pay us 80% of an approved amount with the exception of covered laboratory services which are paid at 100%. You will be responsible for 20% of the approved amount, any deductible portion, and non-covered services at the time of your visit. If you have secondary insurance that pays after Medicare, we will file this claim as well. No Insurance: If you have NO insurance coverage, payment in full is expected at the time of service, unless you have made prior arrangements with our billing department. Statements: You will receive a statement if the amount due is your responsibility OR we have not received correspondence back from your insurance carrier following submission of treatment charges. If you feel your insurance company is responsible for payments which have been denied, or have paid incorrectly, please contact your insurance company directly to resolve the issue. Diability or Family Medical Leave Act (FMLA) forms: If you are in need of our office to complete Disability or Family Meave Medical Act forms, please complete the necessary information that is required by you, sign it, and send it to our office as soon as possible. Forms CANNOT be completed as you wait. Please allow 5-7 buisness days for completion of any forms submitted. Additionally, there is a $10.00 charge, payable prior to completion, for each form to be completed. Awaiting Referrals: If you are waiting for a referral to a specialist and it is not an HMO insurance plan please feel free to phone the business office at 419-224-5915. All insurances respond to authorizations at different time frames. We appreciate your patience.
|
|
USEFUL LINKS
|
|
|
The American Heart Association |
Mended Hearts, Inc. |
|
HeartInfo.org |
The American Stroke Association |
|
|
|
