Payment Options

There are many insurance companies that now require you to have an authorization number or referral form from your primary care physician in order to see a specialist.We accept Master Card, Visa and Discover. 

Identity Theft Protection:  We are required to have the most current information on our patients, including insurance information, address and phone.  We will be asking for your photo ID and insurance card at EVERY visit.  Please bring these cards to avoid a delay in being seen. We will also be confirming this information each time you call our office. 

Co-Pays: Co-payment is due at the time of service. This is a requirement by your insurance company.

We are participating physicians with Medicare. Charges for services rendered to Medicare patients will be filed with the Indiana carrier.Referrals:  There are many insurance companies that now require you to have an authorization number or referral form from your primary care physician in order to see a specialist. We ask that you please obtain this from your primary care physician prior to your visit and bring it to the appointment. This is a requirement by your insurance company.

Blue Shield/AnthemWe are Preferred Providers of Blue Shield/Anthem. If you have this coverage, we will file a claim with them for office visits, as well as other services (excluded are cosmetic procedures). The patient will be responsible for any deductibles, co-insurance and noncovered services.

Medicare: We are participating physicians with Medicare. Charges for services rendered to Medicare patients will be filed with the Indiana carrier. Medicare patients are responsible for the deductible, 20% co-insurance and any noncovered services.

Medicaid: We are not Medicaid providers. Patients who are covered by Medicaid (as primary or secondary insurance) must seek medical care by an Indiana Medicaid provider.

Treatment of Minors: We realize that many families are in a state of change. In many of these families, the question of who is financially responsible for the child’s care is complicated. In the case of either sole legal custody or joint legal custody arrangements, the parent who presents the child for treatment will be considered the financially responsible party for the minor child. 

Account Balances and Returned Checks:  If a check is returned to us for insufficient funds, an additional $20.00 fee will be applied to your account. Unless payment is received within 2 weeks of the insufficient funds notice, your account will be referred to our collection agency with an additional fee attached. As a courtesy, our office will mail out monthly statements of balances due. Accounts with a balance due after 90 days will be considered delinquent and will be sent to a collection agency with an additional fee attached.

Cosmetic Procedures: Cosmetic procedures must be paid at the time of service. We do not file claims to your insurance for cosmetic procedures. There will be a $100 charge for all COSMETIC appointments that are not canceled 24 hours prior to the scheduled time.

Cancelled Appointments:
There will be a $30 charge for all medical appointments and a $100 charge for all surgery appointments that are not canceled 24 hours prior to the scheduled time.

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