Health Insurances Accepted At Rock Ridge Family Medicine
Insurance is a complicated thing to get used to for many people, especially if you are just starting out using it for the first time. It’s especially frustrating if you get to the checkout or signup counter thinking your insurance company is going to pay for everything, or if you do not fully understand what your co-pay amounts are. Below is some helpful advice on insurance for medical reasons at Rock Ridge Family Medicine.
We are a small personal family practice with low out-of-pocket costs and do not share the same practices as large conventional hospitals. Please read below.
Rock Ridge Family Medicine accepts the following insurances.
We do not accept the following insurance providers…
- Work Comp
- ProviDR Care
- Harrington Health
- Auto (MVA)
You will be responsible for paying Rock Ridge Family Medicine for the services according to the individual plan benefits determined by your insurance company, not by Rock Ridge Family Medicine.
Self Pay Pricing
- New patient $140.00 — Does not include labs, x-rays, procedures, injection, meds or OMT
- Est patient $80.00 — Does not include labs, x-rays, procedures, injection, meds or OMT
- Nurse visit (provider order required) $35.00
Subject to change without notice. The prices above are not exact, just an average so you have an idea of what to expect.
All patients are required to put a $140 deposit to cover the copays, co-insurance or deductibles. Money that is over the co-pay will be reissued back to you.
Statements will be sent out via mail for 90 days. On day 120, the statement will include a message that payment is needed in 30 days or it gets sent to collections.
Once sent to collections, you will be dismissed from our practice along with your family if they are dependant on you financially. Once dismissed, you are not allowed back into our clinic.
We are a small family clinic, we just cannot afford to have a higher percentage of people not paying their bill, so we have to be strict with this policy.
You are able to make payments to debt up to the 120-day notice, after the notice payment in full must be received.
Payments can be made in person, over the phone, postal mail and Paypal.
For Billing Questions
For any billing questions, please contact Mike Salach directly @ 913-638-8030. If after hours, please leave a message and he will get back to you as soon as possible. The medical office will not answer billing questions. All questions can be answered by your insurance company. Your insurance company makes the decision in regard to your bill and if you disagree with that decision, you will need to contact the insurance company for appeals. Please call Mike Salach and LEAVE a message.
Give your name, the patient’s name, the medical facility, your phone number and time that can be reached. Leave a short description of your concern. Please allow 24-48 hours for a return call if you have to leave a message.
Have questions about your bill? Call your insurance company for an explanation or check your EOB.
RRFM following guides of the AOA and AOBFP, not all insurance policies will cover Eval, treatment plans, labs, and procedures. Please consult your insurance company for coverage.
MAKE A PAYMENT ONLINE
Include Tricare HealthNet Federal service to insurance that RRFM does not file.
Will Insurance Cover Everything?
Health insurance coverage is complicated and can be hard to understand. Here are some helpful points to remember.
You will be responsible for paying each provider for their services according to the individual plan benefits determined by your insurance company, not by your provider. These might include:
- Co-insurance – The fixed percentage of the allowed charge that the member’s contract denotes as the patient’s responsibility. These amounts can be collected at the time of service by contracting providers. Co-insurance amounts are generally 10, 20 or 50 percent.
- Co-pay, Co-payment – A specific set amount of patients are required by their contract to pay on a given service. These amounts are not percentages of an allowance like co-insurance but are a flat fee per the service. An example would be a $25 co-pay for an office visit. A co-payment does not accumulate towards a specific maximum. Co-pay, co-payments are due at the time of appointment.
- Deductible – A specified amount of out-of-pocket expense that a patient must pay in a benefit period before reimbursement will begin. These services must be submitted so that the incurred expenses may be calculated toward satisfying the deductible amount. Deductible amounts range from $0-$10,000. Deductible amounts can be collected at the time of service by a contracting provider.
- Pre-Authorizations/Referrals – Many insurance plans state that this is the patient’s responsibility and you may want to verify this with your insurance carrier prior to your services.
- Non-covered procedures – Many insurance companies have exclusions into their policies. The exclusions will be a patient out of the pocket expense.
- Questions to Ask – You should call your insurance company and ask if the services you are scheduling are covered by your plan and what you might owe on any procedures done in this office or by a specialist.
When calling your insurance company specifically ask these questions…
- What is my co-pay?
- What is my deductible?
- What is my co-insurance out-of-pocket maximum?
- What is my cost for a “fill this in” procedure?
- Record the name of the person(s) you speak with and the date of the conversation.
Statements – It is possible you might get services from multiple providers and thus, receive bills from their entities also. ie: Lab, pathology, sleep lab, etc. – For Example: If you get lab work done as part of your visit, the blood work might get sent to a specialized lab that tests for specific things in your blood, so you would get a separate bill from the lab.
When you receive a bill and have a question, please refer to your EOB (explanation of benefits) or call your insurance company.
Preferred Providers – It is your responsibility to notify staff of their insurances preferred labs, specialists, pharmacy, medications, etc.