B I L L I N G
you for choosing Neel Raya MD Inc. for your health care needs. Neel Raya MD
Inc. is committed to the improved health of our patients by providing
appropriate, high quality, comprehensive family health care. For every
commitment, there is an obligation. We feel it is the patient or guardians’
responsibility to meet their financial obligations.
As we see patients from many different insurance plans, it is impossible for us
to know all the covered benefits, copays, and deductibles for each plan. While
it is our intention to assist you, it is still your responsibility to ensure
that all services rendered or referred by Neel Raya MD Inc. on your behalf are
paid in full. In order to clarify Neel Raya MD Inc.’s billing procedure, we
have listed below our billing policy.
Patients Without Insurance Coverage
Payment at the time of
service is required.
Contracted, PPO & HMO Patients that have a
Co-payment or Deductible
Co-pays, deductibles and
any balances from previous visits must
be paid at the time of service, as required by your insurance company.
We reserve the rights to
collect $150 from NEW PATIENTS at their first visit, while awaiting payment
from their insurance.
If you do not pay your
co-pay, or balances due at the time of service, your appointment may have to be
rescheduled and it will be considered as a no-show and subject to no-show fee
There may be situations
where you may be left with a balance when unknown co-pays, deductibles or
non-covered services exist. This balance is due
30 days from the date on the billing statement you will receive. You will not
receive a statement of a balance due from our office until after your insurance
carrier has paid their portion of the charges, applied them to your deductible
or requested that you provide additional information.
We will bill Medicare for
you. You will receive a statement after Medicare has paid their portion of the
charges or applied them to your deductible.
If you have supplemental
insurance to Medicare, we will also bill your Medicare Supplement for
You will receive a
statement from our office after Medicare and your supplemental insurance has
paid their portion of the charges or applied them to your deductible.
We accept patients on the
Ohio State Medicaid Programs.
Patients on the Medicaid
program are required to present a current medical card to the receptionist upon
arrival at each visit.
If you do not have your
current medical card upon arrival, you may be asked to reschedule your
appointment to a time when you have your medical card.
Workers Compensation Claims
If you are seeing one of
our providers for an injury that occurred during the course of your employment,
please be sure to notify the receptionist that your injury is “work-related”.
You will be given the proper paperwork to be filed with your employer and their
insurance carrier for payment of your services.
If your employer or their
insurance carrier denies your claim, you will be held financially responsible
for all charges incurred for services rendered on your behalf.
Other Insurance Carriers
As a courtesy to all our
patients, we will bill your primary insurance for you. You will, however, be expected
to pay at the time services are rendered.
We will reimburse you for
any payment we receive if and when your insurance pays us directly.
Civil Suits, Auto, Home or Business Owners Claims
If you are involved in a
civil suit, auto, home or business owner’s accident and are seeking payment
from the responsible party, we expect payment at the time of service.
We do not bill the
responsible parties insurance or attorney for your services in these situations
due to the length of time it takes to settle these claims.
When is payment expected from the patient?
We do expect payment at
the time of service.
If we are on contract with
an insurance company, we expect the patient's portion of our fee, co-pay, balances
from earlier visits, or deductible at the time of service.
We accept cash, check, or
Credit-card (there is a transaction fee) as payment options.
you charge interest?
We reserve the right to
charge interest if payment is not made within 30 days of the service.
We charge $30 for each
If after reasonable
efforts on our part we do not receive payments for services rendered we will
place the patient in collections and after this we will not be able to see the
patient until the owed balance is cleared.
New Patient Visit – or existing
patient not seen for 3 years - $150
Follow Visit – patients seen
within last 12 months - $90
Follow Visit – patients seen
over 12 months and within 36 months - $120
BP-Check by nurse - $10
EKG - $30
Pneumovaccine - $50
Fluvaccine - $35
Prescription Refills - $5
per prescription to a local Pharmacy. We will need these accounts to have
a zero balance when a prescription needs to be called, balances may be paid on
phone via a credit card, and a transaction fee will apply.
Paperwork fee $5 per page,
detailed paperwork will require a visit.