Phone: 559.781.8500 | Fax: 559.781.8300
Insurance Information
You will be given a number of forms to complete and sign before you see the provider of your choice. The forms are very important for you total health care and for the successful billing and collection of your insurance.
To ensure that your paper work is processed as expeditiously as possible, please make sure the following insurance information is available at all times:
- » A current copy of your insurance card
- » Your full name and address
- » Policyholder’s name and address
- » Your relationship to the policyholder
- » Contract number, certificate number and/or group number
- » Name and billing address of insurance company
- » Telephone number of insurance company
- » Effective date of insurance coverage
It is your responsibility to inform us of any insurance changes. It is not uncommon for you to have different insurance coverage from one year to the next. The change could be as minor as a group/policy number or the carrier itself. Insurance companies impose stringent timely filing deadlines. Failure to provide updated insurance information in a timely manner could result in the insurance carrier rejecting payment for your services.
Contracted Insurance Companies
If you have insurance and we have a contract with your carrier, we will bill your insurance, provided we have your current insurance information and it is complete. We require the appropriate co-payment or deductible at the time of service. If your insurance carrier has not paid your balance within 30 days of billing, we will request your assistance in contacting them and require that you begin making monthly payments to eliminate the outstanding balance. Ultimately, you are responsible for the charges incurred services rendered.
Non-Contracted Insurance Companies
If you have a non-contracting insurance, we will still bill your insurance as a courtesy. Again, co-payments and deductibles are due at the time of service. If your insurance has not paid your balance in 30 day of our billing, you will be responsible for resolving the balance on the account.
No Insurance/Cash
If you do not have insurance, payment in full will be required at time of service unless arrangements have been made prior to the appointment.
Medicare
We are Medicare providers and accept what Medicare allows as our payment in full - less any coinsurance or remaining deductible. Our insurance department will bill Medicare for you as well as any secondary insurance you may have on assignment. Payment for any non covered services and/or supplies will be expected at the time of service.
Obstetrical-Prenatal Care and Delivery
For patients requiring Obstetrical/Pregnancy Care, your insurance will be verified on or before your first visit. A monthly payment plan will be prepared for you based on your insurance coverage. Payments will be required monthly and should end with your portion paid one month prior to your delivery date.
Gynecological-Surgery
For patients requiring surgery, again your insurance will be verified prior to your scheduling of surgery. A payment plan will be prepared for you for your portion. In the case of elective surgeries, your portion must be paid prior to the surgery.
Billing Statements
Billing statements are mailed once a month for all outstanding balances. If your insurance has paid, or you have no insurance, the balance on this statement is due in full unless prior arrangements are made with your account coordinator. If your insurance has not paid within the required 30 days, this statement will provide you with the information you need to follow-up with the insurance carrier for payment. Please note that we accept most credit cards as an option for making payments.
Occasionally, circumstances arise that make the required payment on your account a severe hardship. Please do not ignore your bill. Contact our account coordinator as soon as possible to see what other arrangements can be made. Porterville Women's Medical Associates is willing to work with our patients whenever possible.
Returned Checks
Should we receive your check back from the bank for insufficient funds or any other reason, there will be a $25 returned check fee. This fee, as well as the original amount, is due in our office within 10 days after notification. Porterville Women's Medical Associates. does participate in the County of Kern Bad Check Enforcement Program and will pursue payment on any returned check that goes unpaid.
Other Information
Over the past years, the federal government has implemented a number of regulatory guidelines regarding billing practices by physicians. These stringent guidelines are monitored through the Department of Health and Human Services Office of the Inspector General (OIG). As a health care provider, Porterville Women's Medical Associates has chosen to adhere to the OIG regulations, consequently, we do not offer a “professional courtesy” (i.e., waiving of co-payments or deductibles) to any patient. We have an established fee schedule and we adhere to it.
We hope this assists you in understanding our financial policies and again, invite you to ask any question that may not have been addressed here.