INSURANCE BENEFITS (IN-NETWORK AND OUT-OF-NETWORK)
For the convenience of our patients, the doctors at Artisan Pediatric Eyecare have in-network status with many insurance companies. For these insurance companies we automatically submit claims for you and collect the office visit co-pay or the estimated patient responsibility amount at check-in.
Artisan Pediatric Eyecare is in-network with most insurances, including many:
- Commercial Plans (typically provided by an employer)
- Medicaid Plans (through Idaho Medicaid)
- Exchange Plans (purchased on the insurance marketplace)
- Specialty Networks (utilized by some employers and insurance companies)
In addition to being in-network many insurances, our office also works with out-of-network insurances. With out-of-network insurance companies, our office can submit claims as a courtesy if allowed by the insurance company.
What does this mean? Depending upon your insurance (in-network or out-of-network), you will pay either your co-payment, your co-insurance, or the cost of the visit at check-in.
INSURANCE CLAIMS:
In order to properly bill your insurance company we require that you disclose all insurance information including primary and secondary insurance, as well as any change of insurance information prior to your appointment. Failure to provide complete insurance information may result in patient responsibility for the entire cost of the appointment.
Please keep in mind, insurance benefits and coverage is a contract between you and your insurance company. Although we may utilize online tools provided by your insurance company to estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits when the claim processes.
NON-COVERED SERVICES:
If services are not covered, you will be asked to pay for those services at the time of the visit.
At appointment check-in we collect a standard deposit when co-payment information is not available. This amount will be applied toward your family's account. We will refund any overpayment after your claim has processed with your insurance company.
If services provided are not covered by insurance, we require fees to be paid in full at the time services are provided.
SELF-PAY ACCOUNTS:
Self-pay accounts are patients without insurance coverage, patients covered by insurance plans with which our doctors do not participate (are out-of-network), or patients without an insurance card on file with us.
Our office does not accept attorney letters or contingency payments. Liability cases are considered self-pay accounts.
YOUR CO-PAYS AND CO-INSURANCE AMOUNTS ARE COLLECTED AT CHECK-IN:
We accept cash, checks, online payments, debit cards, Visa, MasterCard, Discover, American Express and CareCredit.
RETURNED CHECKS:
The charge for a returned check is $35.00, payable by cash or money order only. The amount due is the insufficient funds amount plus the $35.00 returned check fee. Your account may be placed on a cash only basis following any returned check.
OUTSTANDING BALANCE POLICY:
It is our office policy that all amounts are due at time time of service. In the event a patient has an account balance, due to a returned check or insurance balance, one phone call will be made to the person financially responsible for the account in an attempt to collect the balance due. Our office does not mail monthly billing statements.
Any account balance not paid within 30 days will be sent to the collection agency. In the event an account is turned over for collection, the person financially responsible for the account will be responsible for all legal fees associated with collection including, but not limited to: Attorney fees, filing fees, and court costs.