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Medical Billing Policy
Insurance and Upfront Payment
Insurance Coverage:
Please provide us with your current insurance information at the time of your appointment. If your insurance changes, notify us immediately. We will bill your insurance company directly.
We will do our best to help you understand how insurance billing works but you are responsible for understanding your insurance benefits, including co-pays, deductibles, coinsurance amounts, and plan coverage limitations.
Co-pays:
Any co-payments (co-pays) are due at the time of service. This payment is required by your insurance company and cannot be waived by our practice.
Self-Pay:
If you do not have insurance or do not wish to use your insurance, payment is due at the time of service. We offer a self-pay discount which covers any services provided during your visits such as doctor evaluation, counseling, and preventive screenings.
High Deductible Plans:
Patients with high deductible insurance plans are required to pay an estimated portion of the visit cost at the time of service.
Estimated Patient Responsibility:
All patients who use insurance at booking are charged the estimated patient responsibility which considers the available copay, deductible, and plan information.
Billing Statements and Payment Methods
Statements:
After your insurance processes the claim, you will receive a billing statement for any remaining balance by email. We will send the statement to the email address you provided at registration. Payment is due within 30 days of receiving the first statement email.
Payment Methods:
We accept all major credit and debit cards. Payments can be made using the payment links sent via email when we send your statement. We accept HSA and FSA cards for payments for visits. The monthly or yearly membership fees are not HSA and FSA eligible.
Payment Plans:
If you are unable to pay the remaining balance on your account, please contact our billing department at info@plushcare.com to discuss payment plan options.
Card on File Policy
All patients, irrespective of insurance or visit type, must maintain a card on file within our secure system. Your card on file will be charged for:
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Visit Fees
Estimated patient responsibility on the day of service
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Remaining Balances
Amounts owed after insurance processing
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Administrative Fees
Fees, penalties, and recurring membership charges
Outstanding Balances and Financial Assistance
Balances Overdue:
If you have outstanding balances, you may be required to pay your balance in full before scheduling future appointments unless a payment plan is in place.
Financial Hardship Assistance:
We understand that medical expenses can be burdensome. If you are experiencing financial hardship, please contact our billing department at info@plushcare.com to discuss potential assistance options and payment plans.
Insurance Claim Handling
Denials:
If your insurance denies a claim, we will notify you. It is your responsibility to resolve any coverage issues with your insurance company. We can assist by providing necessary documentation. Ultimately, you are responsible for paying any denied claims.
Appeals:
Should you wish to appeal a denial or if you have any questions or concerns, please contact our billing department at info@plushcare.com.
Frequently Asked Questions
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Do I need to have a card on file to be a patient at the practice?
Yes. This is our policy, and it's becoming common in healthcare. Your payment amount remains the same. When you visit us for treatment, the patient is responsible for covering the cost.
Patients with high deductible plans typically bear more of the payment responsibility. To ensure timely payments, we require a guarantee of payment, like hotels and car rentals which require a credit card on file. -
Do I benefit from having a card on file?
Yes. With a credit card on file, you can seamlessly pay for future visits and will not need to worry about receiving statements or mailing payments. This streamlines the booking and billing processing, making it easier and faster for patients. It also allows our office staff to focus more on providing exceptional care. -
What if I need to dispute my bill?
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What if I have questions about any of my charges?
In the end, it's up to you to understand which services are covered, their frequency, and the extent of your financial responsibility. Any part of the service not covered by your insurance falls under your responsibility. If you have concerns about how your insurance provider handled the claim, please contact your insurance provider’s customer service department directly. -
Are payment plans available if I can’t pay it all at once?
Yes–rest assured, we currently offer affordable monthly payment plans as low as $25/month. The date of your first paid installment will be the date your payment is due each month. Please be advised that we will reach out via email every 3-4 weeks to remind you of this payment due date and allow time for you to complete the installment.
If no payment or communication is received after the final reminder is sent, your card on file will be charged for the remaining balance. If you wish to re-initiate this payment plan, you may do so by contacting our billing department after fulfilling the installment due.
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What if I have more questions that are not answered here?
Please contact us directly at billing@plushcare.com.
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What if I have a question about your refund policy?
Read more about our refund policy here.