Thank you for choosing us as your health care provider. We are committed to your welfare and will do our best to provide you with the best urologic care possible.

Insurance Coverage
We cannot bill your insurance company unless you provide us with accurate insurance information. In the event we do not accept assignment of benefits, we require that you be pre approved on our extended-payment plan or provide a credit card with authorization to bill that account for the balance. If your insurance company has not paid your account in full within 60 days, the balance will be automatically transferred to your credit card or to the extended-payment plan. Please be aware that some, and perhaps all of the services we provide my not be covered by your insurance or may not be considered necessary under the Medicare Program and/or other medical insurance. The balance is your responsibility whether or not your insurance pays.

Insurance Co-Pays
If we are a participant provider for your particular insurance health plan, please be advised that all co-pays are due prior to treatment. In the event that your insurance coverage changes or we do not participate with your particular health plan, please see the paragraph regarding self-payment.

Medicare
If you are covered by Medicare and do not have any secondary insurance, we require 20% of the allowable charge be paid at the time of service.

Self-Pay
If you have no insurance or we do not participate with your insurance plan, we require 50% of the bill payment at the time of your first visit. For elective surgery, we will require payment of 100% of the surgeons fees in advance. We accept cash, personal checks, post-dated checks or VISA / MASTERCARD. We also offer an extended payment plan with prior credit approval.

Minor Patients
Parents or adult guardians accompanying minor patients to the office are responsible for full payment. For unaccompanied minors, non-emergency treatment will be denied unless charges and permission to treat have been pre-authorized. Payment will be in the form of an approved credit plan, VISA/MASTERCARD, or payment with cash or check at the time service.

Surgery
Responsibility for payment of surgical fees is the direct responsibility of the patient. We will submit insurance forms for payment of these procedures. All patients who are scheduled to have surgery must furnish this office with complete insurance information, as we must contact your insurance company and get approval prior to performing any surgical procedures. All surgical balances are due within 60 days after the insurance has paid its portion.

Questions Regarding Financial Policy
If you have any questions or concerns regarding this policy, feel free to contact our Financial Office at 301-645-7735.