Common use of Insurance Changes Clause in Contracts

Insurance Changes. If you have had any changes in your coverage, please notify us. Even a small discrepancy can lead to a denial of payment. All co-payments are collected at the date of service. Past due balances are due at the date of service unless previous arrangements have been made with an insurance counselor. Insurance deductibles and fees for service not covered by your insurance policy are due at the time of service. An example of a non-covered service is REFRACTION (unless you have a vision plan). REFRACTION is a procedure necessary for eye doctors to evaluate your vision and/or write glasses prescriptions. Unfortunately, many insurance companies, including Medicare, do not cover this procedure. Our fee for this service is $45, and is expected at the time of check-out. This fee is subject to change. If, for any reason, you are unable to pay for services at the date of service, we will reschedule your appointment. Our office accepts VISA, MasterCard, American Express, Discover, cash, money orders and checks. No post-dated checks will be accepted. Any bounced check will incur a $35 charge. You are responsible for your payment in full at the time of service. NO SURPRISES ACT

Insurance Changes. If you have had any changes in your coverage, please notify us. Even a small discrepancy can lead to a denial of payment. All co-payments are collected at the date of service. Past due balances are due at the date of service unless previous arrangements have been made with an insurance counselor. Insurance deductibles and fees for service not covered by your insurance policy are due at the time of service. An example of a non-covered service is REFRACTION (unless you have a vision plan). REFRACTION is a procedure necessary for eye doctors to evaluate your vision and/or write glasses prescriptions. Unfortunately, many insurance companies, including Medicare, do not cover this procedure. Our fee for this service is $45, and is expected at the time of check-out. This fee is subject to change. If, for any reason, you are unable to pay for services at the date of service, we will reschedule your appointment. Our office accepts VISA, MasterCard, American Express, Discover, cash, money orders and checks. No post-dated checks will be accepted. Any bounced check will incur a $35 charge. You are responsible for your payment in full at the time of service. NO SURPRISES ACTACT In accordance with the No Surprises Act, you are entitled to receive a Good Faith Estimate for services not covered by insurance or if you are a self-pay patient.