EDINA SPORTS + FAMILY MEDICINE
COLLECTION POLICIES AND PROCEDURES
- We require that all copays are due at the time of service and are collected by the front desk staff. For your convenience, we accept cash, checks, debit cards, Visa, MasterCard and American Express.
- We file insurance electronically for all insurance companies within the United States as a courtesy to our patients. For insurance companies that ESHW does not have a formal
contract with, an “Assignment of Benefits” form must be filled out completely, be signed and dated before submission of the claim. - Statements will be sent to patients if we have received a remittance from the insurance indicating a patient’s additional responsibility for payment. Statements are generated monthly and may be followed by collection procedures if payment in full is not received.
- All Private Pay Charges are eligible for a 10% discount if paid in full at the time of service by cash, check or credit card.
- New patients with no current insurance or pro of of insurance at the time of service are considered “private pay”. Payment for the initial date of service is required at the time of service and eligible for a 10% discount.
- Due to increased deductibles and unpaid patient balances, we feel it necessary to adjust our Payment Agreement Policy as follows:
$0.00 – $100.00
Balance = Payment in Full within 30 days
$101.00 – $300.00
Balance = Minimum Payment of $100.00 within 30 days.
$301.00 +
Balance = Minimum Payment of 1/3 of the balance within 30 days.
