Financial Policy


Lancaster Urology accepts insurance from most major insurance companies. All services provided are the patient's responsibility. As a courtesy, we will file claims with your insurance carriers provided we are supplied with your current insurance information. A copy of your insurance card and prescription card will be made at the time of your visit. If your insurance requires a referral/authorization from your primary care physician, you should present the form at check-in. Failure to provide us with a referral/authorization will result in your appointment being rescheduled.

Insurance coverage is a contract between the patient and the insurance carrier. We participate with many insurance carriers and we will endeavor to assist you in filing your claim, and receiving payment from your insurance carrier. Your insurance carrier requires us to collect copayments, deductible and co-insurance. We collect copayments at time of service. Deductibles and co-insurance amounts are collected prior to procedures being scheduled. We will verify your eligibility and benefits with your insurance carrier and will collect an estimate of our fee for services. It will not include the facility, lab or pathology fees. When you have a procedure performed by our physician, you will receive a separate fee for those services when applicable. If we are not a participating provider (out of network) with your plan: Payment is due at time of service. As a courtesy we will submit a claim to your insurance. 

Please contact your insurance carrier to verify your benefits as some preventive procedures and wellness visits are not covered. All labs or x-rays should be verified with your carrier for the correct location, or your insurance may fail to pay. Please inform us if your insurance carrier has a designated lab/facility. If your insurance requires pre-certification, please inform our staff so that we may assist you in this process. Failure to obtain pre-certification or authorization at the correct facility will result in the entire balance being the patient's responsibility.

When you have a procedure performed by our physician, you will receive:

 

We accept all major credit cards (MasterCard, VISA, Discover, and American Express), cash money orders, certified checks or personal checks; however, personal checks must be paid 7 days prior to procedures being performed.

All procedures are scheduled in advance. If you must cancel a procedure or office visit, kindly give 24 hours notice so another patient may utilize your appointment slot. If you fail to notify us a, $25.00 fee will be charged. Continued cancellation of appointments will result in additional fees and may result in dismissal from the practice.

Each month you will receive a statement for services that have not been paid, which is due and payable upon receipt. If payment is late or you have not previously made financial arrangements, a reminder notice will be sent. In the event the account remains unpaid, Lancaster Urology may turn the account over to collections. By signing this Financial Policy you: 1. agree to pay Lancaster Urology reasonable collection costs as allowed by the laws of the Commonwealth of Pennsylvania 2. agree you will be responsible for any and all costs associated with the collection of your account, including any reasonable attorneys' fees.

You agree, in order for us to service your account or to collect monies you may owe, Lancaster Urology and/or our agents may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or emails, using any email address you provide to use. Methods of contact may include using pre-recorded/artificial voice messages and/or use of automatic dialing device as applicable.
In the event that any monies paid, by you result in an overpayment of $25.00 or less, those monies will be applied first to any previous balance you may have and will remain on your account as a credit to a future visit. You may at any time request in writing any credited funds available on your account.

I have read and fully understand the financial policy set forth by Lancaster Urology and I agree to the terms of this policy. I also understand and agree that the terms of the financial policy may be amended by the practice at any time without prior notification.

 

 

4/10/2017