Payment policy of the 400 North Medical Center

Payment is due upon services being rendered.

As a courtesy, we will file your insurance for you or complete any obligations as stated in our contractual agreement with your insurance company.

In regards to fees for services rendered for personal liability such as car accident, or personal injury, it will be the responsibility of the patient to forward the necessary information to the third-party responsible for payment.  If you request, a claim form will be forwarded to you as a courtesy. Payment for services rendered will be due from the patient.  Payment for services rendered will not be held for the patient’s settlement of their claim against the third party liability.

Services rendered for work comp injuries will be billed to the Work Comp carrier or employer only if prior approval has been obtained.  Treatment for unapproved work related injury will be the responsibility of the patient and payment will be expected at the time of treatment.

Co-payments are to be made at the time of service per your insurance company guidelines and our contractual agreement with your insurance company.  Co-payments not made at the time of service may jeopardize your ability to obtain services in the future.

Statements will be sent on a monthly basis or as balance due on the account changes.  Payment is due within 28 days from the date the statement is received.

Patients without any insurance coverage will be required to make payment in full at time of service.  A 20% discount will be offered off of services rendered.  This discount is allowed due to the decrease of business office expenses regarding billing insurance.

If the patient is unable to make payment in full, upon physician approval, a payment arrangement will be set up for patients with no health insurance.

  1. When a patient arrives at the office, the patient’s balance due will be reviewed.  Patients with a current balance due (as indicated on the patient’s account as Patient) will be asked if they would like to make a payment on their account.

  1. Co-payments will be collected prior to any medical services being rendered.  Patients who are unable to make their co-payment for the day will be given a self addressed envelope and a payment date will be requested by the staff. This will be documented in the billing system under “NOTES” and this information will be forwarded onto the billing staff for appropriate follow up.

  1. Past due patient balances will be collected at the time of the patient’s visit. If they are unable to make payment on the patient due portion on their accounts the patient will be directed to the Office Manager for payment arrangements.

    • Payment arrangements will be set up by dividing the patient due balance by 6 months.
    • New charges will be expected to be paid in full as they incur the charges.
    • Failed payment arrangements will be reviewed by the physicians to determine if medical care will be continued.
  1. Statements are sent out weekly by provider.  The schedule is as follows:

Week 1:  Duneland Internal Medicine

Week 2:  Minesh Patel, PC

Week 3:  Maurice Ndukuw, PC A-L

Week 4: Maurice Ndukwu, PC M-Z

  1. The first statement is mailed and patients have 28 days to pay the bill.

  1. If a Second statement goes out, it is stamped, PAST DUE.

  1. If a third statement is mailed and no patient payment has been made, a letter from the Office Manager is send.  This letter requests the patient contact our office to set up a payment arrangement or a payment date as to when they will be making a payment.  The accounts are marked “COLLECTION ACCOUNT”.  Appointments may be scheduled, but need to be transferred to the Office Manager first.

  2. Ten days to fourteen days after the collection letter (indicated in #7) has been mailed, a call from the Business Office staff is to be made as a “courtesy call” asking the patient to pay for the outstanding balance or set up a payment plan.

  1. If a fourth statement is mailed, the patient is terminated  from that physicians practice.  Urgent services will be offered for 30 days from the date of the letter.  The account is then marked “TERMINATED”.  Appointments cannot be scheduled on these accounts.  Terminated patients must make payment in full before another appointment can be scheduled.  Special arrangements can be made via physician approval.

  1. If it is determined that medical care can no longer be extended to the patient due to failure to make appropriate payment or non-compliance of medical instructions, the patient will receive a letter informing them that emergent medical services will be provided to them over the next 30 days or until they can transfer their medical care to another health care provider (or which ever comes first).

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