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Financial Responsibility Policy

Insurance Billing

Submitting Claims

  • If we are an in-network provider with your insurance carrier, the »Ê¹Ú²ÊƱ Health Center can submit a claim on your behalf. The patient/responsible party is responsible for all co-pays, co-insurance and deductibles.
  • It is your right to choose to pay for your services at the self-pay rate and not have a claim submitted on your behalf. This applies even if you are covered under an insurance plan for which »Ê¹Ú²ÊƱ Health Center is an in-network provider.

Guarantee of Payment

  • If any of the charges incurred at the »Ê¹Ú²ÊƱ Health Center are not paid by medical insurance, the balance due is the responsibility of the patient/responsible party.
  • Should it become necessary to resort to outside collection procedures, the »Ê¹Ú²ÊƱ Health Center reserves the right to charge the patient its collection costs and reasonable attorney fees.
  • The patient/responsible party must return any equipment provided by »Ê¹Ú²ÊƱ Health Center for home use. If the patient/responsible party fails to return medical equipment, the patient/responsible party must pay the Health Center any associated costs for replacement.

Out-of-Network Plans, Referral or Authorization of Services

  • It is the patient/responsible party's responsibility to obtain precertification, referral or authorization of services if this is required by the patient's carrier prior to the visit.
  • Payment for services denied due to a failure to comply with the notification requirements of the insurance company will be the patient/responsible party's responsibility.
  • The patient/responsible party may have greater financial responsibility for services provided by health care professionals at the »Ê¹Ú²ÊƱ Health Center if they are not under contract in the patient's health care plan.
  • It is the patient/responsible party's responsibility to direct questions regarding coverage or verification of benefit levels to the patient/responsible party's health care plan.

Self-Pay

  • All payments are due in full at the time of service. We accept cash, check, debit, major credit cards and health spending accounts.
  • Please call 773-298-3712 for current pricing.

Contact

If you have any questions about your financial responsibility when visiting the »Ê¹Ú²ÊƱ Health Center, please contact the Health Center Director, Kathy Rohan, at 773-298-3749.