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Emergencies
Pinnacle Sports Medicine & Orthopaedics, P.A. defines "Emergencies" as a condition that presents a threat of loss of life or limb without medical intervention. The Physicians believe in treating Emergencies regardless of a patient's ability to pay.
To make our services available for those who need them, we must receive prompt payment for the services we provide. We reserve the right to withhold treatment for non-emergency patients that refuse to make satisfactory payment arrangements upon request.
Payments
We accept cash, check, credit, and debit cards (Visa, MasterCard & Discover Only). A $30.00 returned check fee will be assessed for any returned checks.
Surgical Fees, Deposits & Payment Plans
Surgical fees depend on the nature of the procedure and the complexity of care. We will prepare an estimate of your charges based on the planned surgery and information we obtain from your insurance company. However, unplanned events or emergencies during surgery may require additional fees. Assistant surgeon fees may also apply. We ask that you plan to pay the estimate of charges at the time of your pre-operative appointment for surgeries.
Insurance Coverage
From time to time we have had patients who assume that their insurance company will pay all their medical bills in full. Very few insurance companies cover 100% of all medical bills. In most cases, there will be a deductible, co-payment, and/or co-insurance that patients must pay out-of-pocket. Often insurance companies deny payment for "non-covered" services. Patients are billed for non-covered services. Each patient is responsible for providing accurate information to us and ultimately paying for services not covered by insurance. Pinnacle Sports Medicine & Orthopaedics, P.A. is committed to assisting our patients in determining and controlling the cost of their medical care.
We bill most insurance plans as a courtesy to our patients. We ask that you provide complete and up-to-date billing information to allow us to submit accurate claims. We automatically file all Medicare, Medicaid, and Worker's Compensation claims. Medicaid (including First Guard and Health Wave) cardholders are asked for their cards at the initial visit and each subsequent visit. Patients who do not follow the guidelines set by their insurance will be responsible for denied services. This includes failure to obtain required referrals per your insurance plan.
Should you disagree with the way your insurance company has paid a claim we suggest that you first contact your insurance company. Second, we do not have the means of knowing the specific coverage of your plan. If in discussion with your insurance company you learn that we did something wrong then please advise our billing office of the error. Please also advise us of the insurance person with whom you discussed the problem as well as their phone number so that we can properly follow up with the problem.
Regardless of your insurance coverage, your account becomes your responsibility after 60 days from Date of Service.
Insurance Co-Payments
If your insurance plan requires that you pay a co-payment, you are expected to pay this at the time of service. A $15.00 billing fee will be added to visits where the co-payment was not paid at the time of service.
Uninsured Patients
New patients who do not have insurance coverage will be required to Pay-In-Advance for all services until credit is established. Exceptions may be made in Emergency cases. Established patients with a poor payment history will be required to pay for all services in advance of receiving the service.
Worker's Compensation
We provide medical services for work-related injuries. An Accident report and Authorization from your Employer is required. Patients will be billed for unauthorized services. Progress reports are provided to your employer and workers compensation insurance companies as required by law.
Accidents Not Related to Health Insurance
From time to time, patients may encounter injuries resulting from an accident, where liability or automobile insurance may be involved. We will bill these insurance companies only when proper documentation is received. We reserve the right to expect payment in full at the time of service.
Bankruptcy
We reserve the right to treat accounts included in Bankruptcy on a case-by-case basis. We may terminate bankrupt patients from our practice which may require the patient and their family to seek medical care elsewhere. Patients allowed to remain in the practice will be designated as Pay-In-Advance. If you have insurance we may charge you the full price for the service and then refund amounts overpaid after your insurance company makes payment to us. Credit will not be extended with the exception of emergency services.
Statements
Statements are mailed monthly. These will show you what is pending with insurance and what co-insurance or deductible amount that you may owe. Payment is expected within 10 days.
Refunds and Small Balances
Refunds are made after all insurance claims have been settled.
Collections
Accounts with services over 60 days old are considered Past Due. Our billing office staff will make reasonable attempts to notify you if your account has reached a Past Due status. It is important that all changes in your name, address, phone number, insurance, or employment be relayed to our office as it can affect the billing of your account. If we are unable to locate a patient, payment is not received, or satisfactory payment arrangements are not made, then an account will be considered for referral to our collection agency. We reserve the right to treat accounts referred for Collections on a case-by-case basis. Patients may be terminated from the practice at our discretion, which requires the patient to seek medical care elsewhere. Patients with poor paying accounts who are allowed to remain in the practice will be designated as Pay-In-Advance. Patients with old, past due balances will be required to bring their account current before care such as, appointments, prescription refills or telephonic medical advice will be provided. Credit will not be extended with the exception of emergency services.
Lack of Cooperation
We are blessed with patients that assist us in completing our work in an efficient and accurate manner. We believe that all patients should be treated with dignity regardless of their ability to pay. We reserve the right to terminate a patient from the practice in those rare cases when a patient may be verbally or physically abusive, refuses to give necessary information, or is non-compliant with medical advice.
Commitment to Quality
Pinnacle Sports Medicine & Orthopaedics, PA is committed to Continuous Quality Improvement. On occasion errors may occur and we appreciate your assistance in correcting them. If you are treated in an unprofessional manner, if there are services you would like to see us provide, or if you have any comments or suggestions that allow us to serve you better, please do not hesitate to notify us.
2. Correspondence may be mailed to Quality Assurance, Personal & Confidential, Pinnacle Sports Medicine & Orthopaedics , PA , 1818 East 23rd Avenue , Hutchinson , KS 67502-1106.
3. Phone Calls should be directed to Administrative Staff at (620) 662-6000.
