• Practice Policies

COPAYMENTS / INSURANCE DEDUCTIBLES and BILLING GUIDELINES

Copayments and insurance deductibles represent the portion of our services that patients must pay out of pocket. Such payments are required by the patient’s agreement with the insurance payor. We are contractually obligated to collect them. We are not allowed to waive copays or deductibles. Medicare law requires collection of deductibles and co-payments, and waiver of such payments constitutes fraud. To comply with our contracts, we require payment in full at the time of services including any co-payments and deductibles. Any payment past due must be made before the next scheduled visit can proceed. This means that if you have not paid your prior co-payment or deductible, your visit may be rescheduled until payment is made.

 If we do not participate with your particular insurance company, as a courtesy we may submit your charges to your insurance company. If your insurance company does not pay the full amount due Arthritis Health Associates, you may be billed for the remaining balance. Please see list at left for the insurance companies with which we participate.

A finance charge at the rate of 1 ½ % per month will be added to all unpaid balances more than 60 days past due. There may be additional charges added to your account to collect any unpaid bills, including but not limited to: late fees; reasonable attorney fees;   court costs and collection agency fees. Additionally, there will be a $25 service charge to your account for all returned checks.

We invite you to call our office to pay your personal balance with your credit card: VISA, MASTERCARD and DISCOVER.

Please review your billing statement and contact our dedicated billing staff  at (315 ) 422-1513, option 5, for any questions or clarification of your account. Please note that you will receive a statement from us within 30 days after your insurance has paid (if a balance is due).  We encourage you to call to discuss payment plan options if you are unable to pay your account in full. 

 

NO SHOW AND LATE CANCELLATION APPOINTMENTS

In an effort to provide quality care to our patients, we must utilize our time efficiently. When a patient makes an appointment, time is set aside for their needs, and work is performed to prepare their record for the visit. When a scheduled visit is not completed, there is a loss for another patient who could have used that available time, as well as wasted staff time. Therefore, we ask that when a scheduled visit cannot be met, it be cancelled at least twenty-four hours prior to the time of the appointment. For late cancellations or not showing for a scheduled appointment, a $25 fee will be charged.

SWITCHING DOCTORS WITHIN AHA

All doctors at AHA are fully qualified in the practice of rheumatology. If you have a preference for a particular physician please let us know when scheduling the first visit. Every reasonable attempt will be made to accommodate your preference. In order to maintain continuity of care and avoid "opinion shopping" within the practice, subsequent requests for switching doctors must be approved by the physicians involved, and in general will be denied. An exception to this policy often occurs if the patient has moved to a new geographical area making such a switch most reasonable for all concerned.

CIVILITY

At AHA, we chose to live and work in a culture of service supported by an atmosphere of mutual respect, human dignity, patience, and civility. The expression of these values is expected consistently from everyone including staff, physicians, patients and their families. Failures by our staff to follow this policy will result in corrective action and potential discharge from employment. Abusive or demeaning behavior towards our staff or physicians by patients or family may result in our withdrawal from the patient’s medical care.

TEAM STRUCTURE OF CARE AT AHA 

A chronic shortage of rheumatologists exists throughout the US. In most practices, waiting times for a new patient to see a rheumatologist is 2 to 6 months, and many rheumatologists struggle to meet the needs for follow-up care of existing patients. The shortage is projected to worsen over the next 20 years. The American College of Rheumatology has recommended the integration of Nurse Practitioners (NP) and Physician Assistants (PA) as an important way to address this shortage and extend the ability of qualified rheumatologists to meet the demands for specialty care within their communities. As a result, AHA has created teams wherein physicians and skillfully trained and supervised NP/PAs work in a coordinated fashion to see patients in a timely manner and reduce the risk of complications or delay. The expanded physician schedules provided by the NP/PAs have successfully reduced wait times substantially, while maintaining the capacity for personalized care.

The value of this integrated model of scheduling with the rheumatologist  and NP/PAs means that when someone calls for an appointment, a visit can be provided with the minimum of delay. To maintain the success of this strategy, patients will typically see the NP/PA intermittently through the course of care. On any visit, if necessary, patients may be seen by both the rheumatologist and NP/PA.

Therefore, as a policy at AHA patients are discouraged from insisting on seeing only the physician as this may result in delays and inefficiency in scheduling needed care.

Click here for more information on the roles of NP/PAs within our office.

COMPLAINTS, PRAISE AND IDEAS

The Staff at AHA is dedicated to providing the best rheumatologic care possible in an experience of efficiency and respect. We are continually in the process of improvement. We welcome your input on how we can do a better job.

Participating

Health Plans:

Below please find an abbreviated list of insurance plans we participate with at Arthritis Health Associates. Although we may not be contracted with your specific plan we will courtesy bill all insurances with the following exceptions:

We are currently not accepting any new patients for Worker Compensation, Medicaid or No-Fault Insurance.

 

  • AARP
  • Aetna PPO & HMO
  • Blue Shield/Excellus
  • CDPHP
  • Champus/Tricare
  • Cigna PPO & HMO
  • Empire Blue Cross Blue Shield
  • Empire-Unitedhealthcare
  • Fidelis Care
  • GHI – GHI HMO
  • Healthnet – Healthnet Pearl
  • Healthnow
  • Medicare
  • MVP
  • Rmsco PPO
  • RR Medicare
  • Today’s Option - American Progressive
  • Total Care
  • Touchstone
  • Unite

     

    dhealthcare PPO & HMO
  • Wellcare

 

 

Copyright 2016