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Know Your Plan
This is the smartest thing you can do! Having an insurance
card does not mean
everything will be paid for! Be a good
consumer and research your insurance plan. Find
out what your plan covers/doesn’t cover for
well care – visits, immunizations, lab work.
Know how much your deductible, co-pay and
co-insurance amounts are so you can be
prepared financially.
Newborns :
Often times the baby is
covered under the mother’s insurance for charges
incurred during the hospital stay. But,
your new baby will be seen in our office fairly
shortly after birth and your insurance
company will apply these charges to the baby’s
coverage. Therefore, it is very important
to have all paperwork needed to add the baby
to your insurance policy prepared in
advance of the baby’s birth. The best plan is to have
the required form(s) ready to go with your
human resource department only needing the
few last minute basic facts (name and date
of birth). The insurance company generally
allows you thirty days from the baby’s
birth to add the baby to the policy; but, they will
be denying claims in the meantime resulting
in you having to pay attention to insurance
problems during the early days of your time
with your baby.
Deductibles, Co-pays, Co-insurance, and Non-Covered Services
: Each insurance
policy has its particular parameters but
most coverage will involve at least one, if not
all four of these patient responsibilities.
Each of these are separate items and having
responsibility for one does not eliminate
responsibility for others.
- A
deductible is a set dollar amount that you must pay
before your insurance
company assumes
responsibility. The deductible amount is set by your
employer
and is due when you
receive a statement from us.
- A
co-pay
is an amount you must pay at each visit as specified by your
insurance
carrier. The amount of
the co-pay is set by your employer and may be required for
all visits - well or sick.
- A co-insurance
is a percentage of the charge
your employer has determined to
be your responsibility. The actual dollar amount is based on
the amount allowed
by your insurance carrier
after any contractual adjustments. The co-insurance
amount is due when you
receive a statement from us.
- Not all
services may be covered by your insurance. We will be
notified by your
insurance company once
they have processed your claim and these charges will
be turned over to your
responsibility. Payment for non-covered
services is due
when you receive a
statement from us.
Please contact us at (847) 398-0400 if you have any
further questions.
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