Payment Policy

Thank you for choosing Physical Medicine & Pain Physicians for your healthcare needs. We strive to deliver the best in standard of care for our patients. We understand you have choices and appreciate your trust in our services.

We would like to explain to you our payment policy.

At Physical Medicine & Pain Physicians we see patients with or without insurance coverage. For patients without insurance coverage or covered by managed care plans with which we have no contract, we expect payment at the time of service.

We offer a discount of 20 % for all cash payments made at the time of service.

For patients with insurance, our staff will file a claim with your primary and secondary insurance plans as a courtesy to you.

If a patient co-pay is due, we expect payment at the time of registration. For your convenience, we accept cash, checks, money orders and credit card for payment. Either of these options may be used to at the front desk and for payment of balance as mentioned in your statement. We will send payment balance statements every month and remind you of payment due when we call to confirm your follow up appointment. Payments due must be paid within two months (60 days) from the date of initial statement. If it becomes necessary to place your account with a collection agency, all costs related to this process will be your responsibility.

We understand that there can be a situation where payment of balance may have to be delayed or be paid in installments. In such a situation, we will be happy to work with you on a payment plan. Our front desk staff will help you with the details of such an arrangement.

If your visit involves a Worker’s Compensation claim, we expect written documentation from your employer / claim adjustor verifying the worker’s compensation status and information regarding the injury and coverage. Without this documentation, payment for the visit will be your responsibility.

For visits or procedures that may not be covered by your insurance, you will be asked to sign an Advanced Beneficiary Notice.

Our Billing professionals are available to assist you in negotiating with your insurance plan for timely payments. However any balance remaining on your account for more that 60 days will be considered your responsibility and will be billed to you.

I acknowledge that I have read and agree with all of the above:

( Signature of patient or authorized representative) (Printed name) (Date)