Endovascular Consultants of Colorado, PC
We are committed to providing you with quality and affordable health care. Because some of our patients have questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy. Please read it carefully, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.
- Insurance. We participate in most insurance plans, including Medicare. If you are
not insured by a plan we are contracted with; payment is expected at each visit. If you are insured by a plan we are contracted with, but don’t have an up-to-date insurance card, payment for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.
- Co-Payments and Deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failing to collect co-payments and deductibles could violate our insurance contracts with federal and private insurance companies.
- Non-Covered Services. Please be aware that some — and perhaps all — of the services you receive may be noncovered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services at the time of your visit.
- Proof of Insurance. All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
- Claim Submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
- Coverage Changes. If your insurance changes, please notify us immediately so we can make the appropriate changes to help you receive your maximum benefits.
Thank you for your understanding of our payment policy. Please let us know if you have any questions or concerns.
I have read and understood the above information, and agree to accept the conditions:
