Patient Financial Policy

We are committed to providing you with the best possible care, and your understanding of our Patient Financial Policy is important to our professional relationship. Please ask if you have any questions about our fees, policies, or your financial responsibilities. You may also reach us at 316-685-6222. Carefully review the following information:

BILLING, INSURANCE AND PAYMENT

We participate with most local and many national insurance plans. However, it is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive. If you are covered by health insurance, you should be prepared to show the most recent copy of your insurance card at every office visit. As a courtesy, we will file your claim with your primary and secondary insurance plans if you provide complete and accurate information about your insurance. You will be responsible for deductibles, co-payments, non-covered services, co-insurance and items considered “not medically” necessary by your insurance company. Your copayment is due at the time of service. If you are unable to pay the required copayment, your visit will be rescheduled.

If your insurance company pays you directly, you should receive payment within 30 days of billing. You will be responsible for full charges until Kansas Surgical Consultants, LLP receives the insurance check and summary of claims processed from the insured patient. After 60 days, if we have not heard from you, accounts will be considered for collections and we will expect payment of the full charges.

If you do not have health insurance, we expect payment at the time of the service. General surgery patients will be required to pay $200.00 at the initial visit. Breast cancer patients will be required to pay $400 at the initial visit. If you are unprepared to pay, your appointment will be rescheduled. We do offer financial discounts for uninsured patients who may need surgery. A financial agreement will be obtained prior to services being performed. Please contact our business office at 316-685-6222 if you have any questions. Please be aware our returned check fee is $50.00.

CANCELLATION/RESCHEDULE POLICY

Procedures/Surgical Services:
Kansas Surgical Consultants will charge $50 if you cancel or reschedule your procedure within 7 days of the service date. Less than 7 days’ notice does not allow us time to fill the open time on the surgeon’s schedule. This fee will not be applied toward the procedure and will be added as a charge to your account. It will not be billed to your insurance policy. This $50 fee must be paid prior to rescheduling your appointment.

Office Appointments: Kansas Surgical Consultants will charge $50 if you cancel or reschedule your office appointment within 24 business hours of the service date. Less than 24 business hours notice does not allow us time to fill the open time on the surgeon’s schedule. This fee will not be applied toward the office visit and will be added as a charge to your account. It will not be billed to your insurance policy. This $50 fee must be paid prior to rescheduling your appointment.

REFERRALS

If your insurance policy requires a formal referral to our office, we will do our best to help you obtain any referral forms required by your insurance provider. If we are unable to obtain the referral for any reason, we will let you know. It will then be your responsibility to contact your primary care physician and obtain the referral prior to your appointment. Failure to obtain a referral may result in a reduction of benefits or non-payment by your insurance provider.

WORKER’S COMPENSATION

If your office visit is due to an injury at work that has been reported to and verified by your employer, you may be eligible to have your claim covered by Worker’s Compensation insurance. Be sure to inform our receptionist that the injury occurred while on the job. You will need to provide all claim information and complete a form in order for us to file this claim correctly.

ACCIDENTS AND INJURIES

All medical expenses that result from a vehicle accident or public liability are considered the personal responsibility of the patient.

USUAL, CUSTOMARY, AND REASONABLE

Insurance companies pay an established percentage of the physician’s fee or pay the insurance plan’s customary or reasonable fees, whichever is less. Although these limits are called customary, they may or may not reflect the fees that physicians charge. You may also notice that on your invoice, the fee your physician has charged is higher than the reimbursement from your insurance company. This does not mean your physician is overcharging you for those services. The insurance company may not have taken into account up-to-date, regional data in determining the amount paid for services. There is no regulation on how insurance companies determine the amount paid for services. The language used in this process may be inconsistent among insurance companies and difficult to understand.

UNDERSTANDING YOUR HEALTHCARE

Our office and surgery charge is determined after each visit and procedure. You, your doctor, or your insurance company may call us to obtain an estimate of the approximate charges in advance of the service. Please be aware that you will receive separate billing from other providers or entities related to your surgical services or procedure (radiologist, anesthesiologists, pathologists, surgeons, etc.) as well as facility fees.

FORMS AND RECORDS

The completion of disability forms and FMLA forms will incur a $25.00 administrative charge per set of forms. Forms will not be completed by KSC until payment is received. There is no charge for duplication of medical records sent directly to another medical provider or records requested by your standard health insurance carrier. Duplication of medical records for personal use, disability policies, life insurance policies, or cancer policies will incur a charge.

COLLECTIONS PROCESS

If we do not receive your payment in full within sixty (60) days of your first mailed statement, and you have not made arrangements with our business office, your account will be considered delinquent and considered for collection action.
If your account is placed in collections you will be charged collection fees including but not limited to agency fees, attorney fees and court costs.