NEEL RAYA MD INC.
B I L L I N G - FEE SCHEDULE
Thank you for choosing
Neel Raya MD Inc. for your health care needs. Neel Raya MD Inc. is committed to
the improved health of our patients by providing appropriate, high quality,
comprehensive family health care. For every commitment, there is an obligation.
We feel it is the patient or guardians’ responsibility to meet their financial
obligations.
As we see patients from many different insurance plans, it is impossible for us
to know all the covered benefits, copays, and deductibles for each plan. While
it is our intention to assist you, it is still your responsibility to ensure
that all services rendered or referred by Neel Raya MD Inc. on your behalf are
paid in full. In order to clarify Neel Raya MD Inc.’s billing procedure, we
have listed below our billing policy.
·
New
Patient Visit – or existing patient not seen for 3 years - $175
·
Follow-up
Visit – if last visit is less than 3 years ago - $110.
·
New
Patient with Commercial Insurances (other
than Medicare, Medicaid, Humana-medicare, Medigold, Aetna-Medicare,
Anthem-Medicare, Caresource-medicaid, Paramount-medicaid, Buckeye-medicaid)
will be charged $50 at first visit, which is refundable after the 2nd
visit when insurance has paid.
·
New
Patient with Medicare, Medicaid, Humana-Medicare, Medigold, Aetna-Medicare,
Anthem-Medicare, Caresource-medicaid, Paramount-medicaid, Buckeye-medicaid,
need to pick up new patient paperwork and provide all insurance required
information prior to making appointment.
·
BP-Check
by nurse - $10
·
EKG
- $30
·
Giving
injections (medicine provided by patient) $10.
·
·
Co-pays,
deductibles and any balances from previous visits must be paid at the time of
service, as required by your insurance company.
·
If you do not pay your co-pay, or balances due at
the time of service, your appointment may have to be rescheduled and it will be
considered as a no-show and subject to no-show fee of $30.
·
There may be situations where you may be left with a
balance when unknown co-pays, deductibles or non-covered services exist. This
balance is due 30 days from the date on the billing statement you will
receive. You will not receive a statement of a balance due from our office
until after your insurance carrier has paid their portion of the charges,
applied them to your deductible or requested that you provide additional
information.
·
We will bill Medicare for you. You will receive a
statement after Medicare has paid their portion of the charges or applied them
to your deductible.
·
If you have supplemental insurance to Medicare, we
will also bill your Medicare Supplement for you.
·
You will receive a statement from our office after
Medicare and your supplemental insurance has paid their portion of the charges
or applied them to your deductible.
·
We accept patients on the Ohio State Medicaid
Programs.
·
Caresource/Paqramount/Buckeye-medicaid plans should
have Dr.Raya’s name on the card at appointment, without this name on the card
patient will not be seen or scheduled.
·
Patients on the Medicaid program are required to
present a current medical card to the receptionist upon arrival at each
visit.
·
If you do not have your current medical card upon
arrival, you will be rescheduled for your appointment to a time when you have
your medical card.
·
If you are seeing one of our providers for an injury
that occurred during the course of your employment, please be sure to notify
the receptionist that your injury is “work-related”. You will be given the
proper paperwork to be filed with your employer and their insurance carrier for
payment of your services.
·
If your employer or their insurance carrier denies
your claim, you will be held financially responsible for all charges incurred
for services rendered on your behalf.
·
As a courtesy to all our patients, we will bill your
primary insurance for you. You will, however, be expected to pay at the time
services are rendered.
·
We will reimburse you for any payment we receive if
and when your insurance pays us directly.
·
If you are involved in a civil suit, auto, home or
business owner’s accident and are seeking payment from the responsible party,
we expect payment at the time of service.
·
We do not bill the responsible parties insurance or
attorney for your services in these situations due to the length of time it
takes to settle these claims.
·
We do expect payment at the time of service.
·
If we are on contract with an insurance company, we
expect the patient's portion of our fee, co-pay, balances from earlier visits,
or deductible at the time of service.
·
We accept cash, check, or Credit-card (there is a
transaction fee) as payment options.
·
We reserve the right to charge interest if payment
is not made within 30 days of the service.
·
We
charge $40 for each bounced check.
·
There
is a charge for release of records to the patient. Please click on this link.
·
If after reasonable efforts on our part we do not
receive payments for services rendered we will place the patient in collections
and after this we will not be able to see the patient until the owed balance is
cleared.