Midlands Family Medicine - payment and insurance information

Midlands Family Medicine, North Platte Nebraska

PAYMENT POLICIES
We require payment at the time of service. You may pay by check, credit card (MasterCard or VISA) or cash. Any co-payment required by your insurance company is also required at time of service. Please keep in mind that if you fail to make your co-payment you may be in violation of your insurance company's policy and they can use this to remove you from their plan. If you do not have insurance, we expect payment in full on the date that you are seen. If you need to make special arrangements for payment please contact the billing department.

INSURANCE INFORMATION
Midlands Family Medicine is a Preferred Provider Organization for Medicare, UPREHS (Union Pacific Railroad Employees Health Systems), Blue Cross/Blue Shield, Midlands Choice, and Mutually Preferred insurance companies.

Whatever insurance you may have, it is your responsibility to provide us with all group, policy, and individual identification numbers along with any required signatures so that we can bill your insurance correctly. Always bring your insurance card with you to ensure that you receive the benefits you are entitled to under your health plan.

Please note that we will not bill your second or supplemental insurance unless we are a Preferred Provider Organization for that insurance company. If you will be filing your second insurance yourself, be sure to ask for a copy of the fee and diagnosis sheet for that day's visit. You will need this sheet to file your claim with your second insurance company.

DISABILITY FORMS
In the event of an injury or illness that prevents you from working we will complete your disability forms for you. You must complete and sign your section of the form before dropping it off at the clinic. Your signature is required before we can release any of your confidential patient information regarding your disability. You will need to provide us with information regarding any dates of hospitalization, physical therapy performed, or visits to other doctor's offices.
If we do not have all of this information it will prevent us from being able to file your form in a timely manner. Please allow us a few days to complete the forms. Upon completion, you may pick up your disability forms at the reception desk, or, if you prefer, we can mail them to your insurance company when you provide us with a stamped envelope. We can not fax the forms or call your insurance company.

WORKER'S COMPENSATION
We will file Worker's Compensation Claims if you have an on-the-job injury. Please complete a Worker's Compensation Claim form when you arrive at the clinic so we have all the information necessary to properly file the associated charges. You must provide us with the correct company name, address, and a contact telephone number in order for us to be able to file claims for you. If you do not provide this information, we will have to bill your account for the charges related to the accident. If your Workman's Compensation claim is denied by your employer's insurance company you will be responsible for any charges that have been incurred.

DELAYS IN PAYMENT FROM YOUR INSURANCE COMPANY
We will not wait indefinitely for your insurance company to pay on your insurance claims. If a claim becomes 150 days old and you insurer still has not paid on it, you will become responsible for the charge incurred. At this point you will want to call your insurer and find out why they are taking so long to pay on the claim. Please refer to our Credit Policy for more information regarding this issue.