For your convenience, we accept Visa, MasterCard, Debit, Discover, CareCredit, Cash or Check. We deliver the finest care at the most reasonable cost to our patients, therefore payment is due at the time service is rendered unless other arrangements have been made in advance. If you have questions regarding your account, please contact us at the location services were rendered.
Please remember you are fully responsible for all fees charged by this office regardless of your insurance coverage.
We will send you a monthly statement. Most insurance companies will respond within four to eight weeks. Please call our office if your statement does not reflect your insurance payment within that time frame. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated. If you are in need of a payment plan, we are proud to offer Care Credit in our office and can give you the information to apply for this easy, monthly credit plan prior to your procedure.
We are committed to providing you with the best possible care, and we are pleased to discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship. Please ask if you have any questions about fees, the financial policy or your responsibility involved.
FULL PAYMENT IS DUE AT THE TIME OF SERVICE unless arrangements have been made with our office staff, prior to your appointment, because we have verified your insurance benefits, or the doctor has agreed to a payment plan for financial hardship.
If you have insurance, we will help you receive maximum benefits, as long as you are in compliance with this policy. We require payment in full at the consultation visit.
However, we will file your insurance for you, so that you can be
reimbursed by your insurance company directly. On subsequent visits, we
may agree to bill your insurance, if you obtain approval from our office
staff prior to the date of service. If we do agree to bill your
insurance you must pay the amount discussed on the day you are scheduled
for services. We commonly referr to this amount as your estimated
down payment. You may or may not have a balance once we receive payment
from your insurance. If your general dentist or other provider has not
submitted any charges you incurred with them for reimbursement, prior
to our verification of benefits and estimated down payment calculation,
the amount of your down payment may change, and/or result in a balance
owed by you. If
your insurance has not paid your claim within 30 days, YOU are
responsible to have your account balance paid in full 45 days from
the date of service. However, if you are unable to pay
the balance in full, contact our office to arrange a payment plan. If
you have a credit after insurance pays, a refund check will not be
issued to you for at least 60 days. This allows our office enough time to audit
the account for possible overpayment and erroneous payments made by your
insurance carriers. In some cases it takes up to six months or longer
for insurance companies to realize they overpaid. Your account may also
show reversals of INCORRECT payments by your insurance company. When we
do issue a refund, it will never be more than what you paid
out-of-pocket. Insurance overpayments will not be refunded to you
without a letter of authorization from your insurance company. This must
be obtained by you and presented to us for verification. You may pickup
your refund check if you desire. If you misplace your refund check, it
gets lost in the mail or you have moved and did not inform our office
and you require a new refund check to be issued, there will be a stop
payment fee of $25.00 that will be deducted from the former amount of
the refund. However, if the check has expired or has been damaged and
you are able to bring the check, we are happy to reissue the refund at
no additional costs to you. If you do not agree with this
policy, or if the audit period is an inconvenience, you may
pay in full at the time of servce and have your insurance carrier
reimburse you directly.
*A Special note: In situations of divorce, separation, court orders etc., the party initiating the treatment will be financially responsible for the account. We are an UNINVOLVED third party.
Your insurance policy is a contract between you and your insurance company. WE CANNOT GUARANTEE CORRECT PAYMENT OF YOUR CLAIM. Neither you, nor we, can assume that your insurance company will accept our charge as a basis for their reimbursement on what they consider an acceptable fee. If your claim is not paid, the insurance company should explain to you why it was rejected. There are some insurance companies that will only reimburse the member directly. If your plan falls under that category you will be required to pay in full for every visit, as your insurance would not be paying us. A few examples of insurance companies that reimburse the member directly are: any and all Federal Blue Cross plans and some Delta or Washington Dental plans. If you are unsure whether your plan will reimburse you directly, please ask and we can help you find out. The insurance company looks upon your physician's office as a third, uninvolved party.
WE LOOK TO YOU, NOT THE INSURANCE COMPANY FOR ANY UNPAID BALANCES. YOU ARE RESPONSIBLE FOR THE TIMELY PAYMENT OF YOUR ACCOUNT.
Thank you for understanding and complying with our financial policy; please let us know if you have any questions or concerns.
ALASKA ORAL SURGERY GROUP, P.C. MEDICAID FINANCIAL POLICY
We are committed to providing you with the best possible care and are pleased to discuss any questions you may have financially. Your clear understanding of our Medicaid financial agreement is important to our professional relationship.
Alaska Oral Surgery Group, P.C. accepts all Medicaid patients however; adult Medicaid (ages 21 and over) has an annual benefit limit per year of $1,150. Any services that are not listed as a covered benefit through Medicaid, or services provided after your benefits have been exceed, Alaska Oral Surgery Group, P.C. has the right to bill you, the Medicaid beneficiary. We will verify ahead of time what benefits you, the Medicaid beneficiary have available, send in a pre-authorization prior to any treatment as well as provide you with a detailed treatment plan.
I, __________________________________ understand and agree that if I elect to proceed with treatment that is a non-covered procedure by Medicaid or is performed after I have exceeded my benefit limit, I will be held financially responsible and agree to set up a payment plan for the non-covered services prior to treatment.
Thank you for your understanding of our Medicaid financial policy; please let us know if you have any further questions.
ALASKA ORAL SURGERY GROUP, P.C. FINANCIAL POLICY FOR FEDERAL BLUE CROSS AND PREMERA BLUE CROSS
We are committed to providing you with the best possible care and we are pleased to discuss our professional fees with you at any time. Your clear understanding of our financial policy is important to our professional relationship. Please ask any questions you may have regarding our fees, the financial policy or your responsibility.
INSURANCE: Effective May 15, 2013 Alaska Oral Surgery Group, P.C. has contracted with Federal Blue Cross and Premera Blue Cross Blue Shield of Alaska. This means that we are preferred providers for your insurance company. Being a preferred provider means that we will accept payment from your insurance company as payment in full for your covered services. However, deductible, co-insurance, co-payments and over maximum limitations will be collected in full at time of service. Alaska Oral Surgery Group, P.C. will not bill you for services provided that are considered over the allowed amount from your insurance company, but we will collect the difference between the allowed amount and what your insurance actually pays. Federal Blue Cross typically covers 85% of the allowed amount after the deductible has been satisfied and Blue Cross covers 75-90% depending on your plan. This means that after your insurance has processed and paid, you will likely end up with a balance that you will be responsible for.
NON-COVERED SERVICES: Some procedures performed in our office may not be covered by Federal Blue Cross or Premera Blue Cross, if this is the case we will notify you if possible, ahead of time, of the specific services and go over the procedure fees and the amount you would be held responsible for. All non-covered services must be paid in full at the time of service. If this creates an undue burden for you we do offer a payment plan through CareCredit. We offer a 6-month, interest-free payment plan and other extended payment plans that you are able to apply for. These extended plans do charge interest. Please feel free to ask our staff about the details and how to apply.
All remaining balances are due upon receipt once your insurance company has
processed and paid your claim. We will then issue you a statement demonstrating
the remainder balance you must pay. If the insurance company pays and you
have a remainder credit balance on your account, we will audit your account for
correct payment by Blue Cross and a refund will be issued to within 60 days
from the date the final payment was received (please refer to our general
financial policy). Note that you will never be reimbursed more than what you
actually paid out of pocket. Any overpayments made by Blue Cross will be
reimbursed to Blue Cross with a formal request by them.