Financial Policy
The purpose of this policy is to help ensure patients can afford to receive the quality of care they desire. It is our intention that costs be covered, as much as possible, by the patient benefiting from the service provided.
PAYMENT IS DUE AT THE TIME SERVICES ARE RENDERED.
Cash, checks, and Mastercard and Visa credit cards are accepted. Returned checks and outstanding balances older than 30 days, may be subject to a rebilling fee and/or bank charges. You will be asked for Mastercard/Visa information to hold your first appointment. The credit card will only be charged if the appointment is cancelled with less than 48 hours notice.
As a medical provider, we must emphasize that our relationship is with you, not your insurance company. You are responsible for filing for reimbursement with your insurance company. Your receipt will include the medical diagnostic and treatment codes your insurance company will require to process your claim.
Unlike many medical providers, we schedule only one patient for each appointment slot and we allot a full hour for each appointment (2 hours for a new patient), including administrative time, to ensure your medical needs are well served. If you must cancel an appointment, please notify us as soon as you can (leave a message if the office is closed) so that we have a greater chance of being able to serve another patient. You will be charged your full appointment fee for missed/cancelled appointments unless you provide at least 24-hour notice, (48 hours for your initial appointment).
This office does not participate in patients`litigation - Medicaid, Social Security/disability, motor vehicle or other accidents. This office will NOT be available or required to give opinions in reference to your condition including, but not limited to, depositions, hearings, testimony, and/or trials.
Correspondence services, such as copies of medical records, letters, forms, and phone calls with you, or on your behalf, may be performed upon your request or as required for your care. You, or the receiving party, will be billed for such services.
Educating Your Insurance Company
Dr. Moore´s National Provider ID (NPI) is 1629132345
There seems to be a great deal of misunderstanding among insurance administrators as to what DO`s are and how their treatment should be covered. The following information is provided to assist you in understanding for yourself, and in communicating with your insurance provider.
Osteopathic Physicians (DOs) receive the same training and licensing as allopathic physicians (MDs). They have the same medical responsibilities and privileges (e.g., writing prescriptions for lab work and pharmaceuticals). Both MDs and DOs receive training in many different areas of medicine and may specialize in a particular field (pediatrics, gynecology, internal medicine, etc.).
Additionally, DOs are trained in Osteopathic Manipulative Treatment (OMT) for the hands-on diagnosis, treatment, and prevention of illness and injury. All DOs receive training in OMT. Not all DO`s, however, choose to use OMT as a primary method in their practice. Dr. Moore uses OMT in virtually every treatment. In effect, Dr. Moore specializes in OMT, just as another doctor - MD or DO - may specialize in cardiology
Many insurance plans require you to see an "in-network" or "participating" doctor in order to receive the highest level of reimbursement. If there is not an in-network doctor who provides the care (specialty) you need/ desire within a certain distance (commonly 60-100 miles), they may reimburse you at the higher in-network rate for services provided by an out-of-network or non-participating doctor.
Dr. Moore does not "participate" with any insurance plan. While there are a few other D.O.s in the area, none of them specialize in OMT. For this reason, you may be able to receive a higher tier reimbursement for Dr. Moore´s services.
Regarding Purchases: Purchases of nutritional supplements, balls, educational materials, etc. are generally not reimbursed by insurance. To expedite your reimbursement, we recommend you cross out the lines for purchases and sales tax before submitting your receipt for reimbursement. This will prevent questions which may delay your reimbursement.
Anthem Blue Cross Subscribers Only: Dr. Moore´s non-participating provider ID is 180831.
Medicare Subscribers Only: You will pay Dr. Moore after your visit and we will file with Medicare for Medicare to reimburse you. If you have a secondary insurance, you need to call them (the phone number is usually found on the back of your secondary insurance card) to ensure you are set up for "crossover." This tells Medicare to forward your claim on to your secondary insurance and it will speed your reimbursement.
If you have a Medicare Replacement policy, call them and find out the quickest way to receive your reimbursement. While we are required to submit claims to Medicare for your reimbursement, I have been told that Medicare replacement plans fall under different rules. Some plans require you to submit your receipt for reimbursement; if we submit a claim they will pay us and won`t pay you until we return the check as voided (even if we submit the claim with a request to "pay patient"). Some plans will not reimburse you under any circumstances.
print version "educating your insurance company"
updated 10-30-2008 / 16:31.