Payment_and_Billing

Patients receive certain benefits depending on a number of factors which determine eligibility. The first factor is to verify if a premium is required. The patient would have to pay on schedule, if this is required. Monthly base changes can be made for patients who are eligible for Medicaid. When someone is working and he/she has a health plan that is offered within employment, then this becomes a deciding factor to look into. The patient is in a plan’s master list of enrollment and is assigned to a service date due to the PCP. The status of the provider as in-network or out-of network, the providers matter this is in the HMO’s. A patient’s copay amount affects his/her eligibility, and if a service procedure is planned it is covered as well. When an insurance policy does not cover a procedure or a service, the situation is discussed in the main office with the patient. Every patient that is not covered by his/her insurance should be notified and therefore the patient should arrange a financial account. Service performed: Triple Bypass Surgery Estimated charge: 65,000 Date of planned service: October 20, 2010 Reason for exclusion: Triple Bypass Surgery is not covered by their health insurance. I, Spencer Shay, a patient from Dr. Wilmer, I am fully responsible for the full payment charged for this service. I know and accept that my health insurance excludes the service mentioned above. Service to be performed: Intensive Care Unit Estimated charge: 13,000 Date planned service: October 21, 2010 Reason for exclusion: Intensive Care Unit is not covered by insurance I, Spencer Shay, a patient from Dr. Wilmer, I am fully responsible for the full payment charged for this service. I know and accept that my health insurance excludes the service mentioned above.