At Divine Footcare Center, we are committed to providing you with the highest quality care and service. As part of our commitment, we have established the following Financial Responsibility Agreement to ensure clarity and transparency in our billing and payment processes.
1. Insurance Coverage Verification:
It is your responsibility to provide accurate and up-to-date insurance information at the time of registration. We will verify your insurance coverage and benefits as a courtesy, but it is ultimately your responsibility to understand your coverage and any limitations, including deductibles, co-pays, and co-insurance.
2. Co-Payments and Deductibles:
Co-payments and deductibles are due at the time of service. This includes any applicable co-insurance amounts as determined by your insurance plan. We accept various forms of payment, including cash, credit/debit cards, and personal checks.
3. Non-Covered Services:
Some services may not be covered by your insurance plan. In such cases, you are responsible for the full payment of those services. We will inform you in advance of any non-covered services and provide you with an estimate of the associated costs.
4. Billing Statements and Payment Terms:
We will provide you with a detailed billing statement that clearly outlines the services rendered and the corresponding charges. Payment is due upon receipt of the statement. If you have questions or concerns regarding your statement, please contact our billing department promptly.
5. Payment Plans and Financial Assistance:
If you are experiencing financial difficulties, we understand and are here to help. We offer flexible payment plans and can assist you in exploring any available financial assistance programs. Please contact our billing department to discuss your situation and explore possible options.
6. Collection of Unpaid Balances:
In the event of an unpaid balance, we may employ reasonable collection efforts to recover the amount due. This may include sending reminders, contacting you by phone, or engaging with a third-party collection agency. Any associated collection costs will be your responsibility.
7. Updates to Insurance Information:
It is crucial that you notify us promptly of any changes to your insurance coverage or personal information. Failure to provide updated information may result in delays in processing claims and could make you responsible for the full payment of services.
8. Communication and Disputes:
If you have any questions, concerns, or disputes regarding your financial responsibility, we encourage you to contact our billing department. We are committed to addressing and resolving any issues in a fair and timely manner.
By receiving services from Divine Footcare Center, you acknowledge and agree to the terms outlined in this Financial Responsibility Agreement. We appreciate your cooperation and understanding in matters related to financial responsibility.
Please note that this agreement is subject to change, and any updates will be communicated to you through our website or direct notification.
If you have any questions or require further clarification, please don’t hesitate to contact our billing department.
Thank you for choosing Divine Footcare Center as your healthcare provider.
