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Billing Procedures

Primary & Secondary Insurance

Primary Insurance is the party to whom we look for payment first. Secondary Insurance, also known as Supplemental Insurance, usually is liable for the remaining portion after the primary insurance has paid. Please be sure you have provided complete and accurate information on both plans.

By New Jersey statute, the insurance carrier has 30 days to pay a claim. If payment is not received in a reasonable time, (60 days) we will ask for the patient's assistance in working with the carrier for payment. When you, or your employer, select insurance coverage, you are bound to the terms of their contract, It is extremely important that you read and understand your health plan benefits such as any co-payment, deductibles and non-covered services within your plan. It is impossible for us to know your covered benefits, since we work with literally hundreds of different plans, so we encourage you to understand what your coverage includes to avoid frustration for you. Depending on your plan, some services are "non-covered". This means the patient is responsible for these charges.

No Insurance Coverage

Payment at time of service is required. We offer a discount for payment at the time of your visit providing there is absolutely no insurance coverage. The discount will be discussed with our receptionist at time of check out Other forms of accepted payment include Visa, MasterCard, American Express, Discover and Debit Cards.

Workers' Compensation Claims

We file workers' compensation claims; however, there are some requirements prior to filing a claim.

  • Employee must file claim with his employer
  • Employer submits claim to his/her carrier
  • Insurance carrier assigns a claim number, if approved
  • You must provide us with the name and address of the insurance carrier, along with the claim number

Failure to comply with the above may result in a denied claim.

Co-payments

Your insurance company requires you to pay your co-pay at time of service.. Failure to pay this is a violation of your contract with your insurance company. This concept was created by the insurance industry to lower your premium by requiring the patient to pay a co-pay at every visit. Physicians also agreed to lower the amount they would accept as payment in full from the insurance companies because they were promised they would save the cost of sending statements for co-pays. Please don't ask us to bill you, since the cost of sending a statement is often times more than your co-pay. You will be billed a $5 service charge if you do not pay your co-pay at the time of service.

Deductibles

This is an often overlooked or misunderstood issue. When we subscribe to insurance coverage, we agree to a "deductible" amount. The deductible amount is always the patient's responsibility. Until the deductible amount is satisfied, your insurance is not responsible for reimbursement; however, we will submit your claim to the insurance company so the amount will go towards your deductible.