About insurance and billing
- What insurance plans do you accept?
- What about insurance company referrals?
- What about my insurance co-payment and deductible?
- What if I do not have health insurance coverage, or have a large deductible?
- What about medical bills?
- What about insurance claims?
- What about billing problems?
- Medicare
- Workers Compensation and Auto Accidents
What insurance plans do you accept?
We accept the following insurance plans:
- Advantra Freedom
- Aetna Medicare
- Alliance (now One Net Health Plan)
- Anthem: Key Care, Key Advantage, Healthkeepers, Healthchoice
- APWU
- Blue Cross/Blue Shield: PPO, Out of State, HMO, Fair Choice, Blue Choice
- Carefirst BC/BS: Preferred, Select Preferred, PPO Plans, Blue Preferred
- Carefirst NCAS
- CCN: Kaiser PPO
- CHN/Community Health Network
- Choice Care: Health Systems International
- CIGNA: PPO, EPO, Open Access (No Referral), POS, HMO (Needs Referral)
- CIGNA International
- CIGNA Medicare: Medicare Replacement
- Coventry: First Health
- Erickson Advantage: Medicare Replacement
- Evercare: Medicare Replacement
- First Health
- GEHA: Alliance
- Great West: PPO, POS, Open Access
- Guardian: Alliance, One Net
- Humana
- Humana Gold: Virginia Health Network, Medicare Replacement
- Kaiser One Net
- Mail Handlers
- MAMSI: Alliance, MDIPA, Optimum Choice, Direct (One Net Healthplan)
- MDIPA (Requires Referral)
- Medicare Advantage
- Medicare (Highmark) Part B
- Medicare: Railroad (Claims go to UHC)
- Mutual Of Omaha: First Health
- NCPPO: NCAS
- Optimum Choice (Requires Referral)
- One Health: Not One Net health plan
- One Net: Alliance
- Pacific Care: United Health Care (Instead of Medicare)
- Pyramid Life: Instead of Medicare
- Qual-Choice: Southern Health Plan
- Secure Horizons: Medicare Replacement
- Southern Health
- Sterling: Medicare Replacement
- Tricare: Standard, Prime (Prime requires referral)
- Unicare: NCPPO
- United Healthcare: PPO, POS, HMO, EPO, Choice, Choice Plus
- Virginia Health Network: Humana Choice Care Network
- Virginia Physicians Network
- Wellcare (Instead of Medicare)
What about insurance company referrals
If your health plan requires an insurance referral for your visit with us, it is your responsibility to obtain this insurance referral prior to making your office visit or testing appointment. If you are required to have an insurance referral for an office visit or for testing and do not obtain the referral, you will be asked to sign a waiver for your care. You will then be personally responsible for the full charge for the office visit or the testing, which must be paid at the time of service.
What about my insurance co-payment and deductible?
At your initial visit you will need to provide us with your current insurance information. Please bring all of your insurance cards to all office visits. These will be copied at every visit. It is your responsibility to update this information periodically and when any changes occur. Insurance companies and managed care plans have different co-payment, co-insurance and deductible requirements, which vary and often change without our knowledge. All patients, including those patients with Medicare coverage, are expected to meet their full co-payment, co-insurance and deductible requirements at the time of service. We will collect your co-payment prior to each visit. Your co-insurance and deductible should also be paid at the time of service. Patients who do not pay their co-payments, co-insurance and deductibles at the time of each visit are charged an administrative fee, plus an additional fee for each statement sent to them.
Please remember that insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment. Some companies pay fixed allowances for certain procedures and others pay a percentage of the charge. Often a co-payment, co-insurance or deductible amount is due at the time of service. It is your responsibility to know the amount of the office co-payment, co-insurance and your deductible and to promptly pay any co-pay, deductible, co-insurance or other charges not paid by your insurance company at the time of service.
What if I do not have health insurance coverage, or have a large deductible?
Patients without health insurance coverage (self-pay individuals), and those with large deductibles (such as with HSA accounts) will be required to provide valid credit card or similar information prior to receiving services. A deposit may be required before services are provided.
What about medical bills?
Our fees are customary for our specialty and our locations. There is an initial consultation charge. Subsequent office visits and other services vary in charge, depending on the problem, time and services involved. Payment at the time of each visit is expected from all patients for all co-pays, co-insurance and deductibles and for all charges for which the patient is responsible. This helps control our costs for patient care. Payment may be made by cash, check, MasterCard, Visa or Discover.
All patients, including those with high deductibles (such as with Health Savings Accounts), those patients with coverage from a company with which we do not participate, automobile or other accidents, and those without insurance coverage, are expected to pay for all services at the time of the visit. An administrative fee is charged for co-payments and deductibles not paid at the time of service, and an additional fee is charged for each bill sent.
What about insurance claims?
We will submit insurance claims for office visits and testing if we have a contract and are a participating provider with your insurance carrier. We participate with many but not all managed care plans and Medicare. It is YOUR responsibility to determine whether we participate with your health care plan. If you have any questions as to whether we participate with your insurance plan, please ask our billing staff. A listing of the insurance plans we accept is available through our automated telephone system or on our website http://www.neurologycenteroffairfax.com.
Although we will submit charges on your behalf to carriers with whom we participate, the ultimate responsibility for payment of all charges rests with you.
If we do not participate with your insurance plan, we will supply you with the necessary information for you to file with your own insurance company. For diagnostic testing performed in this office, we will file the insurance claims if you provide us with an insurance authorization form and pay any portion (co-payment, co-insurance or deductible) required by your insurance policy.
What about billing problems?
If any questions or problems arise regarding medical bills or insurance matters, please contact our Patient Accounts Office at (703) 876-0813 between 9:00 AM and 5:00 PM weekdays. Medical bills, especially after hospitalization, can be a source of confusion. We will be happy to help you obtain maximum insurance benefits. However, the agreement by your insurance company to pay for medical care is a contract between you and your insurance company.
If unusual circumstances should make it impossible for you to meet your financial obligations, we invite you to call or personally discuss the matter with one of our billing representatives at (703) 876-0813. Doing so will avoid misunderstandings and help keep your account in good standing. Overdue accounts will be pursued for collection and may be reported to the credit bureau.
Medicare
We are a participating provider with Medicare. We are required by law to submit all Medicare claims. PATIENTS SHOULD NOT SUBMIT MEDICARE CLAIMS THEMSELVES, as such duplicate submissions are likely to cause confusion and delays in receiving reimbursement from Medicare. If you provide us with secondary insurance information, we will file a claim to that carrier for any remaining balance, after we receive your Medicare payment and Explanation of Benefits form.
Workers Compensation and Auto Accidents
If you have Workers’ Compensation coverage, it is your responsibility to provide our staff with written confirmation of coverage, so that we may obtain prior authorization for all services. No service can be provided without prior written authorization from your Workers’ Compensation carrier.
If your care is due to injuries sustained in an automobile accident, you are responsible for keeping your account current. Many insurance companies do not pay for coverage under your health insurance plan when you have been involved in an accident.
Disclaimer
The information provided by neurologycenteroffairfax.com is for informational purposes only. Do not rely on neurologycenteroffairfax.com or any site accessed through neurologycenteroffairfax.com for medical advice. The content on this site is not intended to be a substitute for professional medical advice, treatment, or diagnosis. Always consult your physician or other health care provider for any questions you may have regarding a medical condition, diagnosis, or treatment. If you have questions about your health, you should consult your personal physician. If you think you have a medical emergency, dial 911 immediately.