Portal Solutions

Financial Policy

Thank you for choosing Hillside Family Medicine as your health care provider. We are committed to the successful treatment of your condition. Payment of your bill is considered part of your treatment and a clear understanding of our financial policy is important to our professional relationship.

We will bill your insurance as a courtesy to you with a copy of your current insurance card. If you do not have your insurance card, full payment is due at the time of service. We accept cash, check, credit, and debit cards. There will be a $25 charge for returned checks. If payment is not received from your insurance carrier within our contract limits, any balance will be your responsibility.

HMO/PPO/Commercial: All co-payments are due at the time of service. You are responsible for verifying what your insurance plan will cover and that we are providers for your plan.

UCR (USUAL AND CUSTOMARY RATE): We are committed to provide the best treatment possible for our patients and we charge what is usual and customary for our area. If we do not have a contract with your insurance company, you are responsible for payment in full regardless of any insurance company’s arbitrary determination of UCR rates.  I you have any concerns regarding your coverage please call your insurance or contact our billing department.

Noncovered Services:  Any care not paid for by your existing insurance coverage will require payment in full at the time services are provided or upon notice of insurance claim denial.  Since your agreement with your insurance carrier is a private one, we do not routinely research whether a service is covered.  It is the patients’ responsibility to find out if a service is covered prior to the service.

Workers Compensation: If you are here as a result of work related injury, we will require information regarding both health insurance and your employers Workers Compensation insurance. We will require a letter or statement authorizing your treatment from your employer. The letter should include the claim number, address, adjusters name and phone number.  Your employer’s human resource office should be able to assist you with obtaining this information. If payment is not received, the balance is your responsibility.

Accident Claims: If you are here as a result of an auto related injury will be required to pay in full for your services.  We do not bill auto insurance.

Medicare/Medicaid/Champus/Tricare: We do NOT accept assignment for any of these plans.

Self Pay: A minimum deposit of $100 or the actual charges, whichever is less, is due at the time of service for all self-pay patients. Any subsequent visit charges will be due at time of service. If you cannot pay in full, you will need to set up a payment plan with our billing department.

Delinquent accounts: Delinquent accounts may be assigned to a collection agency. All collection costs will be added to your outstanding balance. We cannot be involved in negotiating payment for divorce orders for medical bills. Whichever parent brings the minor child in for treatment will be responsible for payment of the bill regardless of your divorce decree.