Endocrine Associates of FLORIDA, P.A.

Financial Policy

There have been numerous changes in health care in the past few years which is challenging providers to receive payments. We have provided you with guidelines we have implemented in order to maintain standard of care with the best business practices. We want to make your visit to the doctor’s office pleasant and comfortable and would like to avoid any conflict due to insurance coverage concerns.

Please Read All Information and Sign

  1. We will collect your deductible, co-pay, uncovered services, or percent responsibility at the time of visit. Please be prepared to pay before the doctor’s examination.
  2. Please be thorough with your insurance information for filing claims. Always bring your current insurance card(s) and any authorization needed to see the doctor. YOU WILL BE RESPONSIBLE FOR ANY UNPAID BALANCES DUE TO WITHHOLDING INFORMATION.
  3. We file PRIMARY INSURANCE ONLY. If you have multiple insurances YOU will be responsible for submitting the necessary forms to receive reimbursement. If Medicare is the primary, we will file the secondary insurance.
  4. Your insurance will send you an explanation of benefits that explains what they paid your provider. It is recommended you retain this record and if you have a discrepancy with the payments or benefits, please contact the insurance company.
  5. If the insurance denies payment on your claim, you will be requested to remit payment for any claim of services rendered. We accept cash, credit or debit. Any unpaid account over 90 days will be submitted to an outside agency for collections. Persistent unpaid balances will result in being discharged from the practice.
  6. HMO OR PPO PATIENTS REQUIRING A REFERRAL: You are responsible for making sure your primary care physician has sent us the appropriate referral. Our office will not call the referring physician to render care, and will cause a delay in your care. Make sure you have your referral before you arrive to the office.
  7. There is a $25.00 cancellation fee if you fail to notify the office or reschedule within 24 hours in advance of your appointment.
  8. There is a $1.00/page copy or transfer fee, up to $25.00 in accordance to the Florida statutes when medical records are requested by patient.
  9. There is a $25.00 (prepayment) fee for completion of forms which require physician review completion and signature.
  10. We do not participate in Medicaid Insurance plans.

Thank you for your understanding and cooperation with our policies.

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Patient or guardianDate