Payment Policy

Payment Policy - Hopewell Family Care

Thank you for choosing us as your primary care provider. We are committed to providing you with quality and affordable health care. Because some of our patients have had questions regarding patient and insurance responsibility for services rendered, we have been advised to develop this payment policy. Please read it and reach out to ask any questions you may have. A copy will be provided to you upon request.

1. Insurance. We participate in most insurance plans, including Medicare. If you are not insured by a plan we do business with, payment in full is expected at each visit. If you are insured by a plan we do business with, but don’t have an up-to-date insurance card, payment in full for each visit is required until we can verify your coverage. Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage.

2. Co-payments and deductibles. All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment at each visit.

3. Non-covered services. Please be aware that some – and perhaps all – of the services you receive may be noncovered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services in full at the time of visit.

4. Proof of insurance. All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your driver’s license and current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.

5. Claims submission. We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

6. Coverage changes. If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.

7. Nonpayment. If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.

8. Missed appointments. Our policy is to charge for missed appointments not canceled more than 24 hours ahead of the scheduled appointment. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment.

9. Misc. Forms. Please note that any requests for forms presented outside of a visit are subject to fees based on provider time spent on the form in question. This includes FMLA forms, School/sports physical forms, etc…

10. After Hours Calls. Our office maintains an after hours line so we are always available to help our patients determine the need for emergency medical attention. As audio only medicine is not an accepted method for insurance purposes any call which goes beyond this simple determination will be billed directly to the patient.

11. Payment Plans. According to financial need payment plans are available with our office. To request to be put on a payment plan contact the billing department and terms can be discussed. Unless a payment plan is currently in effect with our office all payment are expected in full upon receiving a statement by our patients. If either 2 payments are missed or 90 days elapse without payment a collections agency may be employed to collect unpaid charges with our office.  

12. Denial of Service Due to Open Balances. Our office reserves the right to refuse service to any responsible party with open balances of greater than $100 which have been open for greater than 60 days. In the case that this should occur you will be contacted via the email on file to notify you of the issue. From that point you will be given 2 weeks to rectify the balance before all attached charts are inactivated.

If you agree to the above guidelines, when you visit our office you will be asked to sign a document that states: “I have read and understand the payment policy and agree to abide by its guidelines.”


Sara Davis
Sara has participated with G.O.D. Int'l since 2010. She is a Biblical Studies major at the Institute, and is planning to work in film and journalism in the region of Latin America.
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