Forms & Payment
Accepts new patients
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Medical insurance plans and payment options
Insurance Coverage We accept most major insurance coverage – including most of the local HMOs in Madison, Wisconsin – if you are allowed to go outside of the plan. Please call to confirm we accept your coverage.
Medicare Coverage Please note that our clinic welcomes Medicare assignments. If you carry an HMO secondary insurance, you may have difficulty seeking medical care outside their closed panel of doctors. We would still be happy to treat you if you are willing to pay the 20% copay that Medicare does not cover. You may utilize Mastercard or Visa if you desire.
Managed Care Plans (HMO/PPO) Many patients belong to managed care plans, such as DeanCare, GHC or Physicians Plus. Generally, these organizations are designed to exert greater control over the use of medical care. Therefore, it is important that you have a clear understanding of the requirements and procedures of your plan. For example, most plans require that a primary care physician (PCP) refer you for specialty care and ancillary services (x-ray, lab, physical therapy, braces, etc.). You also may be required to obtain ancillary services from specific facilities.
Managed care plans have a wide variety of procedures that patients are required to follow, and each plan’s requirements vary. If you have a point-of-service option, you may be allowed to see a specialist outside the plan by paying a copayment. Make sure you understand and follow your plan’s rules carefully, otherwise your plan may reduce or deny payment of services.
Copayments Many insurance companies and managed care plans have copayments (copays). In most situations, your insurance card will indicate if a copay is required. If your card does not show whether you owe a copay, please call your insurance provider.
Like most clinics, our clinic requires that you pay your copay at the time of your appointment. Please give your copay to our receptionist when you check in. You may utilize Mastercard or Visa for this payment.
Precertification Many insurance plans require pre-authorization or precertification for hospital admissions. Admissions include surgery and other procedures performed at the hospital. Without proper pre-authorization or precertification, your insurance provider may deny or reduce your benefits. Please review your insurance plan carefully to see if any of these requirements apply.
Disability Insurance If you have an insurance policy that provides income to you while you are disabled, we can assist you with the forms. Our office staff will go through these forms with you, as there may be areas of the forms that you need to fill out. Our clinic will mail these forms within three to five working days. Please allow us enough time to process these completely.
Worker’s Compensation When registering with us, please bring the name and address of your worker’s compensation carrier and your file number.
Billing Procedures As a courtesy to our patients, we will be happy to help you complete and submit medical claims to your primary and secondary insurance, including Medicare. We are always here to assist you, but we rely on you to provide us with current insurance information. Questions that arise regarding your specific insurance coverage are between you and the insurance company, and you should contact your carrier to resolve any difficulties.
You will not receive a bill from our clinic until your insurance provider has processed your claim. If your insurance does not cover the full amount of the bill, you will receive a bill for the remainder of the charge. It is your obligation to pay this portion by the due date listed. If you believe your insurance provider handled your claim incorrectly, please contact your insurance provider directly.
No Insurance / Self Pay Patients In these situations, payment in full is requested at the time of service and 50% of surgical fees are due in advance, unless alternative payment arrangements are made in advance with our office.
Contact Information
Our Team
To learn more about the team at our clinic, please visit the Our Team section of our site.
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