Understanding the Cost of Care
We understand that managing financial stress is a part of ongoing care for chronic, rheumatic conditions. Our financial counseling team is ready to work with you and your family to minimize the financial burden.
Patient Financial Responsibility Policy
We will work with you and your insurance company to provide the most effective treatment options at the most minimal cost to you. The best outcomes are achieved when you and Oregon Rheumatology Specialists work as a team to determine a financial plan. We encourage you to meet with our financial counselor.Please bring the Patient Financial Responsibility Policy with you to your first visit.
Our Legal Responsibilities
If your insurance policy has provisions such as deductibles, co-insurance or co-payments, please note that we cannot legally discount those fees after their submission to your insurance carrier. If we are in your insurance carrier’s network of providers, we are also obligated by contract to collect the balances as outlined by your insurance carrier. Writing off patient responsibility balances could jeopardize our contract. For Medicare patients, we are obligated by law to collect the patient responsibility for co-insurance, co-payment or deductible. We regret if any of these regulatory provisions cause difficulty, but we must comply with insurance contracts and federal law.
Helping You with Insurance Issues
If you have any issues or concerns with your insurance, we will be happy to help resolve them. Please let us know if you have any questions. We have included our complete patient financial responsibility policy for your review below.
How We Work with You
- Oregon Rheumatology Specialists provides verification and review of your insurance benefits. We are not responsible for inaccurate information provided to us by your carrier. The information about your plan that we relay to you is in good faith. If you do not have insurance, our financial counselor will review our company discount policy with you.
- Once your treatment plan is agreed upon, our financial counselor will give you an estimate of your financial responsibility.
- If you feel your estimated cost is not affordable, we need to know immediately, so we can work with you to meet your medical and financial needs before treatment starts. Our financial counselor can give you information on financial assistance options that may be available from a wide variety of local and national resources. If you want to pursue any of the available options, you will need to apply for and receive assistance approval prior to beginning treatment.
Co-payments, Deductibles and Co-Insurance
- Co-payments are collected at the time of check-in. We may also ask for payment on any outstanding patient balances while you are in the office.
- Insurance deductibles and fees for services not covered by your insurance policy are due at the time the service is rendered.
- We accept cash, checks and most major credit and debit cards.
- Oregon Rheumatology Specialists will bill your primary insurance carrier. As a courtesy, we will also bill your secondary insurance carrier. If problems arise regarding coverage issues, we will work with your insurance company to help resolve them. However, please be advised that you are ultimately responsible for payment for medical services provided. After 60 days, any unpaid balances will become the patient’s responsibility.
- Our staff will help you obtain referrals and pre-authorizations. You are responsible for assisting our staff in obtaining any referrals or pre-authorizations that may be required by your insurance plan prior to your appointment.
- It is important for all patients to be informed consumers. You should understand your insurance company’s policies about doctor visits, referral/authorization requirements for specialty care, radiographs, laboratory tests, urgent care facility care, etc. If you have questions, contact your insurance plan.
- We ask that you notify us either in person, by phone or by mail any time you have a change in your insurance or billing information. If you lose insurance coverage, notify us immediately so that the financial assistance process can begin as soon as possible.
- It is important that we have your correct address on file. Please advise us of any change to your address, telephone number or other contact information. We mail our billing statements.
- If you owe additional money after your visit, you will be sent a statement. Statements are mailed on a monthly basis. Payment is expected by the due date noted on your statement.
Failure to Pay
- Past Due accounts may hinder your ability to schedule future appointments.
- Patients who fail to pay their balance risk negative credit ratings and possible dismissal from the practice.
- Returned checks are subject to a $20 fee and your account will be placed on a “cash-only basis.” We will accept payments only by cash or credit card until the balance is cleared.
- Patients over the age of 18 and emancipated minors will be held financially responsible for all charges incurred. If another party is responsible for payment of your account, you must pay your balance in full and negotiate repayment with them outside of our office. This policy includes individuals negotiating divorce agreements.
- Medicare may not cover some of the services your doctor recommends. You will be informed ahead of time and given an Advanced Beneficiary Notice (ABN) to read and sign. The ABN will help you decide whether you want to receive services, knowing you are responsible for payment.
- We expect that you will make every effort to pay your bill promptly. Payment is due at the time services are provided or upon receipt of a statement.
- A refund is issued when an overpayment has been identified. If you feel a refund is due, please contact our office.
- Self-pay patients should be prepared to pay at the time of each visit.
- For worker’s compensation claims, patients must provide the following at time of service: a claim number, name of the carrier, the date of injury, employer at time of injury and name and number of the claim adjuster. Without this information, the patient will be held responsible for all charges, and payment will be collected at time of service.