Insurance and Payment

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Prompt Payment Discounts

For patients who make coinsurance payments on the date of service there will be a prompt payment discount. Coinsurance is the percentage of the charges that an insurance contract leaves as the patient’s responsibility. For example, an insurance contract that pays 70% and leaves 30% coinsurance for the patient to pay. Many insurance policies have coinsurance for the out of network benefits.

This prompt payment discount will apply only to payment made on the date of service. The prompt payment discount applies only when the payment made, with the discount, completely satisfies the anticipated amount due from the patient for that date of service.

If your insurance company sends payment to you, please send the check along with the attached Explanation of Benefits (EOB) to us within 10 days from the date on the check. This will allow us to make appropriate adjustments to the amount you owe. If you cash the check, or fail to provide us with the EOB as requested, you could lose the benefit of both the prompt payment discount as well as any reductions shown on the EOB.

To make calculations convenient, we have rounded discounted coinsurance amounts to
even dollar amounts. There is no prompt payment discount for patients with Medicare or Medicare replacement policies. The estimated patient responsibility is to be paid in full on the date of service. If the final EOB indicates an adjustment to your account, the adjustment will be made and you will be notified. If the estimated patient responsibility is not paid in full on the date of service, a statement fee of $25 will be added to your balance.

Medicare

There is no prompt payment discount for patients with Medicare or Medicare replacement policies. The estimated patient responsibility is to be paid in full on the date of service. If the final EOB indicates an adjustment to your account, the adjustment will be made and you will be notified. If the estimated patient responsibility is not paid in full on the date of service, a statement fee of $25 will be added to your
balance.

Anthem

Unfortunately, we cannot trust your insurance company to pay your bills. We will charge you for services based upon the fee schedule for cash rates. All charges are to be paid on the date of service. We will then file your insurance forms for you. If your insurance company pays anything, they will mail the check to you. You can keep the check.

If Anthem fails to pay you what is owed to you under your contract, we will assist you by providing you with copies of treatment notes and codes.

Additionally:

Disbursement of benefits

Michael G. Cassaro, M.D., P.S.C. will file claims with your insurance companies as a courtesy to you. You will request that payment of benefits be made directly to Michael G. Cassaro, M.D., P.S.C. for any services or supplies furnished to you. You assign directly to Michael G Cassaro, M.D., P.S.C. all medical benefits, if any, other wise payable to you for services rendered. You authorize Michael G. Cassaro, M.D., P.S.C. to release all information necessary to secure the payment of benefits.

You agree that you are responsible for the entire bill, including amounts not paid by your insurance company for any reason. You further agree to pay reasonable collection costs incurred by Michael G. Cassaro, M.D., P.S.C., including bank charges, collection agency fees, court costs, statement fees, attorney fees and reasonable interest of one and one half per cent per month from the date of service.

Medicare

Medicare authorization:

You will request that payment of authorized Medicare benefits be made to Michael G Cassaro, MD, PSC for any services or supplies furnished to you. You authorize any holder of medical information about you to release to the Centers for Medicare & Medicaid Services and its agents any information needed to determine these benefits or the benefits payable for related services.