As a courtesy to you, we will file your insurance claims to the health plans in which our office participates. Please realize that your relationship with the health insurance plan is based upon a contract between you, your employer, and the health plan. All charges relating to the services rendered to you by the Florida Institute for Reproductive Medicine are your responsibility for payment.
If your health insurance plan does not pay within 30 days, you will receive a bill. Once you receive the bill, we ask that you pay your account balance. Any disputes regarding your insurance company’s payment or non-payment for your medical care should be addressed by you directly to your insurance company.
Types of payment accepted:
Cash, Money Order, Check (verified by TeleCheck), American Express, Discover, MasterCard, and Visa.
For checks returned to us by the bank “Unpaid”, there is a charge of $25.00. We expect you to pay either by cash or by money order for both the “Returned Check” and the “Return Check Fee”. These fees must be paid in full prior to your receiving any further treatment or office visit appointments. Your returned check may be turned over to the TeleCheck company for collection.
Most common participating health insurance plans:
Aetna, Blue Cross/Blue Shield, Cigna, Health Options, Humana Health Plan, Mayo Health Plan, Tri-Care, and United Health Care. If your health plan is not listed, please call our Billing Department. They can verify our office’s participation with your health plan.
Our Billing Department specialists are available to answer your co-payment and billing questions on Monday through Friday from 7:00 am until 12 noon and from 1:00 pm until 4:00 pm. The Billing Department’s phone number is 904-399-5775. If your last name begins with “A” through “L”, dial extension #1; if your last name begins with “M” through “Z”, dial extension #2.
Self-Pay status occurs when you have no health insurance coverage, your deductible for the year is not satisfied, our office does not participate in your health plan, or your health plan does not cover your treatment. Please be prepared to pay in full prior to, or at the time of service for your visit, treatment, or surgery.
Regardless of your insurance coverage status, any accounts considered past due must be paid in full prior to your scheduling any office visit or receiving any treatment.
You are expected to present a current, valid insurance card at each visit. All co-payments and past due balances are to be paid in full at the time of service.
If your health insurance has a designated Primary Care Provider (PCP), a prior authorization or referral from your PCP is required for your office visit and/or treatment at the Florida Institute for Reproductive Medicine. Please be prepared to present the prior authorization or referral number to our office staff upon your arrival at our office.
If the authorization or referral number is not provided, you will be asked to either reschedule your appointment or to pay in full for your visit at the time of service. If you do not have the prior authorization or referral from your PCP and you opt for paying for the visit, we expect you to sign a financial waiver taking full responsibility for the payment of your office visit and/or treatment.
If a refund is due to you, the refund will be processed only after your health insurance plan has processed all your claims.
Insurance Claim Processing:
Even when the insurance plan benefit for “Infertility” does not exist, insurance companies will frequently pay nfertility claims in error, leading patients to believe that they have the insurance coverage. Office visits, lab work, and ultrasounds are often paid with the insurance carrier mistakes the infertility treatments for diagnostic testing. Usually, these claims paid in error are corrected within a few months and the insurance payment is returned. If you have not already paid for these services, we will send you a bill asking for prompt payment.
Please remember that your insurance company may request copies of your medical records in order to verify the treatments being performed. We are required by law to code according to the treatment you recieve. Please do not request that we falsify claims or diagnosis codes in order for you to obtain benefits that you do not have.