Return to Policies page                            Financial Policy of Comprehensive Heart Care, Inc.

Filing Your Insurance Claims
It is your choice to see Dr. Roberts, and ultimately your responsibility that he is reimbursed for the services provided to you at his medical practice.  Our office will file your primary and secondary insurance claims(s) for you, but to do this we need your completed patient registration form, and the signed release allowing this office to forward the information necessary to process the claim to your insurer.  Please bring your insurance card with you to every appointment.  If we do not have your current insurance information, you will be responsible for paying for services rendered.  If our office does not receive payment from your insurance carrier within ninety days from the date we have filed your claim, the balance will become your responsibility.  Although your have insurance, you are ultimately responsible for your health care bills.

Paying at the Time of Service
You will be required to pay all deductibles, office visit co-pays and non-covered services at the time of service.  All supplements, patches, etc must be paid for when you pick them up.  We will accept telephone or mail orders to send supplements/ patches to you with valid credit card information.  You will not be able to purchase supplements/patches or schedule an office visit with Dr. Roberts if there is an outstanding or unaddressed patient balance on your account.  Basically, if you owe us money, and the amount is clearly defined, you need to pay us before we provide you with additional services.  This is a medical practice, not a loan institution.

Collection procedures
You will receive a monthly statement if there is a patient balance due on your account.  If your account balance is not paid within ninety days, collection action will be taken.  Please make every effort to keep your balance current and in good standing.  If special arrangements are required, please speak with the receptionist.  The receptionist will direct you to our Office Manager who can determine what arrangements are applicable to your situation.  If your account is transferred to an outside collection agency, you and your immediate family members will be terminated from care with this practice.  If you are terminated, you will be given a thirty day notice to seek a new physician.

I understand the above information and agree to comply with this policy.

Patient/Legal Guardian/Parent Signature                                            Date

Relationship to patient (if other than patient has signed)                                                                            Return to Policies page