HILTON HEALTH CARE FINANCIAL POLICY   (Updated 3/19/08)

Our financial policy has been set up to prevent misunderstandings. We like to acknowledge patients who take a responsible approach to paying for their medical care.

PLEASE BRING YOUR INSURANCE CARD TO EVERY VISIT!   We must keep this information current.  Some cards have perforations; please do not detach this information. Your card (s) will be scanned into our computer system. If they are not legible please request new cards from the insurance company.

CO-PAYS     Co-pays must be paid at the time of service or a $10.00 surcharge will be applied!  Please be aware of the current co-pay and coverage guidelines for your insurance. We do not submit to a secondary insurance for a co-pay unless it is Medicare. We apologize for this inconvenience but we will make sure you have the information needed for you to submit for reimbursement. Please indicate to our billing staff that you will need to submit.

INSURANCE COVERAGE    If you have multiple insurances it is very important to know which is primary for each member of the household. If there are discrepancies or questions pertaining to your insurance, please contact your insurance company directly. Please keep us updated as to your coverage.

MEDICAID   We do require all Medicaid patients to apply for Blue Choice or Preferred Care Option within a month of getting Medicaid coverage. We have phone numbers available to help you with this process. We are aware that there are a few circumstances when this is not possible but the effort must be made. Medicaid Option insurances need to be recertified every year. Please do not let this lapse. It is very difficult for you to re-establish coverage.  We do not participate with Fidelis.

RETURNED CHECKS   There is a $20.00 charge for each returned check. Should this happen more than once you may be put on a cash only basis.   If there is any doubt about writing a check please consider a credit card payment. We accept Visa, Discover, Mastercard and American Express.   

PAYMENT ON ACCOUNT     We must receive payment on accounts in a timely manner. If there is no payment on the balance at 60 days you will receive a payment plan. This needs to be completed and returned in the allowed time or the collection process will begin. If there is no response to our mailings or phone calls, your account will be brought before the doctors and you may be asked to seek your medical care elsewhere. The balance on the account will be turned over to a collection agency at 90 days. Hilton Health Care has the right to charge you reasonable collection and court costs in addition to your past due account balance. We try very hard to keep this from happening. Please work with us.

MISSED APPOINTMENTS An appointment is considered missed if a patient does not cancel prior to the appointment time. Missed appointments may deprive other patients of the opportunity of seeing their provider in a timely fashion. In order to reduce the frequency of these occurrences, we have initiated a policy that a fee of $20.00 will be  charged to the account of the patient who misses an appointment. If an inordinate amount of appointments are missed, a patient may be asked to transfer their care to another office.

We work very hard to provide quality health care and hope we can avoid any payment problems. Communication with our office is crucial. If you have any billing concerns or need to let us know about a change or problem please call our billing dept at 585-392-9100 x252.

Administrative Forms Policy

As of 02/13/2007, there will be a charge for completion of any form(s) not submitted at the time of an office visit. Current fee is $10 for the first page plus $5 for each additional page. This fee is due at the time the form is dropped off.

This charge is necessary due to increasing demands on providers’ time and increasing office expenses.

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Last modified: 07/18/09