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Financial Policy

   Thank you for choosing us as your health care provider.
The following is a statement of our Financial Policy.
 
APPOINTMENTS
The scheduling of an appointment constitutes an agreement to pay for the professional time reserved exclusively for you.
 
Missed Appointments - Our policy is to charge for missed appointments or appointments cancelled with less than 24 hours notice. If you fail to keep a scheduled appointment with a provider, and do not give the office at least 24 hours notice of cancellation, you will be charged a missed appointment fee of $50.00. Insurance plans do not cover these fees; you will be billed directly for this. Failure to pay a no-show fee will be treated according to our policy on unpaid balances, with the exception of collection accounts. The number to call and cancel an appointment 24 hours a day is (903) 593-9999.
 
ALL PATIENTS MUST COMPLETE OUR "PATIENT DATA FORM"
BEFORE BEING SEEN BY A HEALTH CARE PROVIDER.
 
All patients are expected to complete a patient information and financial responsibility form annually. An updated patient information form must be completed anytime there is a change. For Group Insurance patients, A valid insurance card is required to be presented for copying at each visit. Failure to provide correct information at the time of your visit may result in a delay in care and responsibility for the cost of the entire visit.
 
INSURANCE
Our practice accepts insurance from most major insurance companies. It is YOUR responsibility to know your coverage and benefits. As a courtesy, we will file your claim to the respective insurance company. To avoid any misunderstandings regarding payment for professional services, Direct RehabMed requests that you authorize all insurance company payments directly to our practice. If you choose not to do so, all charges will be due and payable by you at the time of service. You will be responsible for any portion of your bill which is denied, applied to deductible, considered a co-payment or co-insurance portion or is considered non-covered by your insurance plan. Working together we can resolve most insurance issues in a mutually acceptable and convenient manner.

WORKERS' COMPENSATION
If you are seeking treatment for a work related injury, we expect you to notify us that this injury was related to your job. We ask that you notify our office in advance of your appointment so that we can verify coverage of your care.
 
MEDICARE
Deductibles and 20% of the allowable charges are due at the time of service. As we are Medicare providers, we will file your insurance claims. If you have a secondary insurance, please check with the front desk to see if we file with that company. Please bring your Medicare Explanation of Benefits (EOB) showing you have met your deductible.
 
PAYMENT OF FEES
ALL CHARGES ARE YOUR RESPONSIBILITY FROM THE DATE THE SERVICES ARE RENDERED.
Any balance on your account over 60 days old, including those balances that insurance has not paid, will be due in full. All accounts over 120 days old will be turned over for collections. We realize that emergencies do arise and may affect timely payments of your account. If such extreme cases do occur, please contact us promptly for assistance in the management of your account. Please understand that payment of your bill is considered a part of your treatment. You have the right to refuse any services rendered to you if you think they are non-covered services or not payable by your insurance company.
 
INSURANCE
We cannot waive co-payments, deductibles, co-insurance or non-covered service amounts defined as patient responsibility under the terms of our contract with the various health plans. Payment of co-payments and co-insurances are due at the time of the office visit. Please be ready to make payment on the day you visit the office. Any remaining balance on your account after the insurance company has processed your claim is due upon receipt of a statement from our office. If a patient is a member of an insurance plan with which we do not participate, our office will also file a claim on the patient's behalf; however, the patient is expected to make payment in full at the time of service. Please contact your insurance company with any questions about your insurance coverage.
 
WORKERS' COMPENSATION
We will file your claim with your company's Workers' Compensation Insurance carrier. In the event you fail to prosecute the claim for Workers' Compensation (for this illness of condition) or it is determined by the Workers' Compensation Board that this illness of condition is not a compensable injury, you will be responsible for the payment of your balance due.
 

 
 
Methods of Payment
Cash, personal check, Visa, MasterCard or American Express are accepted methods of payment to Direct RehabMed East Texas Spine Institute, PA and DRM Business Health, PLLC. Returned check fee is $25.00.
 
Past Due Accounts
All patient-responsible balances that remain delinquent after 120 days, with no response to our requests for payment, may be referred to a collection agency. Once the account is turned over to the collection agency, the patient or responsible party will have to settle the debt with the agency. Please be aware that if a balance remains unpaid, you and/or your immediate family members may be discharged from Direct RehabMed. If this is to occur, you will be notified by certified mail that you have 30 days to find alternative medical care. During that 30 day period, our providers will only be able to treat you on an emergency basis.
 
Please let us know if you are having difficulty paying your account. We may be able to help by setting up a payment plan based on your financial condition, call (903) 593-3101 for assistance.
 
 
MEDICAL RECORDS

If in the future, should you need copies of your medical records, we do charge a $25.00 fee for this service. We require a written release of records to be signed and dated due to the HIPAA Law. It takes our office eight to ten days in order to process a request so please plan ahead.

 

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