FINANCIAL POLICY

To ensure that Doctor Zaidi has financial stability and can continue to provide medical services to the community and region, the following credit policies shall be enforced:

Payment Responsibility:
 The patient or his legal representative is ultimately responsible for all charges incurred.

 
Assignment of Benefits:
 The physician will bill insurance plans as a courtesy to its patients if the patient provides the required insurance information and signs an assignment of benefits statement.

 
Partial Insurance Coverage:
 Patients with insurance policies that cover only a portion of treatment must pay the anticipated insurance payment. This payment may be requested and is due at the time of service. A pre-treatment deposit may be required.

 
Uninsured Patients /
Non-Covered Services:

 Payment for all charges which are not covered by insurance are due and payable at the time of service.

 
Verification of Information:
 All information given regarding the ability to pay, third party insurance, employment, etc. will be subject to verification.

 
Unpaid Insurance Balances:
 Patients may be requested to make full payment of unpaid balances when insurance payments are not received after 60 days from date of billing.

 
Third Party Litigation:
 The physician will not become involved in disputes arising from third party claims (I.e., automobile accidents, liability claims, etc.) with the exception of verified Worker's Compensation claims, or Claims involving Medicare.

 
Prior Unpaid Accounts:
 Prior to providing services, payment of prior outstanding accounts may be requested and should be received or specific payment arrangements be approved by the office manager.

 
Delinquent or Bad Debt Accounts:
 Patients with unpaid delinquent accounts or accounts which have been written off to bad debt may be denied treatment if not medically required.

 
Payment Arrangements:
 If a patient is unable to make full payment of the patient balance when due, periodic, partial payments may be approved in accordance with credit and collection procedures, as authorized by the physician or his designee. A patient financial evaluation may be requested to determine appropriate payment arrangements.

 
Payment Agreements:
 When a balance due cannot be paid at the time of service or when the balance becomes due, a payment agreement may be required in order to approve payment arrangements.

 
Payment Methods:
 The following payment methods will be accepted: cash, check, money order, Visa, MasterCard.

 
Referral for Outside Collection:
 Accounts, which cannot be collected by the physician after normal in-house collection procedures, may be referred to a collection agency, magistrate, or attorney for further collection action in accordance with the physician's established guidelines.

 
Refunds:
 Overpayments will be refunded to the appropriate party, normally the insurance or guarantor. Patients' refunds will not be processed until all active or past due accounts are paid in full. Refunds of less than $5.00 will not be issued unless specifically requested.

 
Miscellaneous Charges:
  There is a $10.00 charge for new patients who do not show for scheduled appointments, and a $5.00 charge for established patients. We require a 24-hour advance notice for cancellations.