Insurance & Payment

We are happy to work with the following health share plans:

• Liberty HealthShare – Accepted (submitted directly to carrier)

• OneShare Health – Accepted (submitted directly to carrier)

• Solidarity HealthShare – Accepted (submitted directly to carrier)

• Samaritan Ministries – Accepted at self-pay rates; reimbursement documents available upon request

• Medi-Share – Accepted (submitted directly to carrier)

For Samaritan Ministries members:
You will be billed at our self-pay rates. We’re happy to provide all necessary documentation for you to submit for reimbursement directly to your Health Share.

If you have questions about how your health share plan works with our office, feel free to contact us at billing@hopewellfamilycare.com!

New Patients (ALL)

$150

• Please Note: Lab Pricing is in addition to New Patient Fee

To establish care, call our office to schedule a wellness exam.

Newborn Wellnesses (infant under 1 year)

$95

Adult and Children Wellness

$110 (children 1 yo and up)

Other Appointments (Newborn to Adult)

$110

These appointments include:

• Lab Draws (lab fees are in addition to appointment costs)

• Lab Review

• Focus Visit

• Well Woman

• Follow-Up

• Ear Flush

• Procedures

• Sick Visit

Nurse Only (Infant, Child, Adult)

$40

Procedures & Treatments

$20 - $200 (in addition to clinic visit fee)

Incision and drainage, minor cut/wound closure, etc.

At this time, we are not accepting any new patients with TennCare/Medicaid coverage.

Additionally, if you are a current patient and have enrolled in TennCare/Medicaid/Medicare without disclosing this to our office, please be aware that this is a violation of our practice policies and may result in dismissal from our practice.

Medicaid regulations prohibit patients from paying out-of-pocket for covered services, even if they wish to do so or are seeing an out-of-network provider. For this reason, withholding Medicaid coverage is not permitted.

This is not a policy unique to our office — it reflects the federal and state requirements all medical practices must follow when it comes to Medicaid participation and billing compliance.

We appreciate your honesty and cooperation as we work to maintain ethical and compliant care for all our patients.

If you have questions about your insurance status or need help understanding these rules, please don’t hesitate to contact our billing office.

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 billing policy. Please read it, ask us any questions you may have, and sign in the space provided. A copy will be provided to you upon request.

1. Insurance. We participate in most insurance plans, including Medicare. 

- You must bring proof of insurance to every appointment. (Physical or digital cards accepted)

- If you are not insured by a plan we do business with, you will be classified as Self Pay and payment in full is expected at the beginning of each visit.

-If you are insured by a plan we do business with, but don’t have an up-to-date proof of insurance, payment in full for each visit is required until we can verify your coverage. If we are able to retroactively submit for coverage, we are happy to do so. 

Knowing your insurance benefits is your responsibility. Please contact your insurance company with any questions you may have regarding your coverage. Billing information and quotes can be requested from billing@hopewellfamilycare.com and must be requested 72 hours or more in advance of the appointment.

2. Copayments and Deductibles. All copayments must be paid on date of service and deductibles when they are received. This arrangement is part of your contract with your insurance company. Failure on our part to collect copayments and deductibles from patients can be considered a contract violation and potentially fraud. Please help us in upholding the law by paying your copayment at each visit.

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

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. Insurance information is to be confirmed at least once a year. 

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 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 with at least 24 hours advance notice. 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 outside of standard office procedure are subject to fees based on provider time spent on the form in question. This includes FMLA forms, School/sports physical forms, etc… All forms requests have a minimum charge of $5 regardless of time spent.

10. After Hours Calls. Our office maintains an after hours line so we are always available to help our patients determine the need for emergent 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. Adding Family Members To You Policy. It is your responsibility to call your carrier and add all newborns to your policy. Carriers allow 30 days to call and add new babies after which point they will typically no longer add babies backdated to their birth date. If babies are not active on the policy by their 1 month appointment with our office payment in full will be expected for all previous appointments at our self pay rate.

12. Payment Plans. Payment plans are available on request. Payment in full is expected unless a payment plan is agreed upon with our office. Payment plans can be resolved with 0% interest if resolved within 3 months. Payment plans scheduled for more than 3 months are subject to 5% interest.

Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area.

Thank you for understanding our payment policy. Please let us know if you have any questions or concerns.