We offer a variety of payment options for your treatment services, in an effort to make Bridgeway Recovery Center more accessible. Those options include submitting claims directly to most insurance companies, accepting various forms of payment and self-pay rates offered.
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Bridgeway Recovery Center
Patient Payment Policy
Bridgeway Recovery Center strives to ensure a clear understanding of your financial responsibility with respect to the medical services we provide. These policies apply to all services rendered.
Co-Pays: We require payment of co-pays at the time of service and reserve the right to refuse treatment.
No Insurance: If you have no insurance, we collect $_____ for your initial office visit, $ _____ on your next attendance. (Note: there may be additional charges to your office visit if injections or individual therapy is required.) If your deductible has not been met yet, we will contact you to arrange payment in full or to set up a payment plan.
Payments: We accept cash, Visa, MasterCard, Discover and Care Credit. We also accept payment by check and debit cards. We hold a credit card number on file to reserve payment arrangement terms Bridgeway Recovery Center will send patients accounts to collections for balances not paid after receipt of two statements unless you make payment arrangements with our billing office. We reserve the right to require payment for services to be made at or before the time of service.
Outstanding balances: We may refuse to see patients with balances over $250, and who are not making regular payments on the balance. If you have an unpaid balance at the end of a billing cycle, we apply a $5 late payment fee to your account. If you make a payment and it is sufficient to pay both the late payment charge and the principle amount due, we apply your payment to the late payment fee due and then we apply the remaining amount to the principal. In the event that your account is placed for collection, a collection fee will be added to your account, along with any attorney fees and/ or court costs that may be necessary for recovery of the outstanding balance. In the event of an NSF check, there will be a $30 NSF charge added to the balance due.
Claim Filing: We happily file your claim with your insurance company as a courtesy. Please keep in mind that payment remains your responsibility. We do not enter disputes over insurance benefits. We bill insurance in accordance with all federal, state and other contractual requirements in cases where we have an agreement, or we are a participating provider. We expect payment in full of you if your insurance company delays processing of your claim for over 60 days. You agree to pay any portion of the charges not covered by insurance. If your insurance company sends payments directly to you, send or drop-off the payment to Bridgeway Recovery Center, and we will apply it to your account.
Preauthorization: Most insurance companies require preauthorization before you have service provided. Failure to obtain preauthorization may result in your insurance company refusing to pay your claim. Any refusal of payment by insurance for this reason is your responsibility.
Dependents: You are responsible for payment of services rendered to your dependent if previous arrangements have been made stating such. In cases where a written court order allows payment for medical costs associated with a dependent, it is the responsibility of you to obtain reimbursement from the other party involved.
Referrals: If you see a doctor that is out of network or if you use an insurance company that requires a referral, you are responsible for obtaining it from your primary care clinic or physician. Failure to obtain it may result in a lower payment or no payment from the insurance company or no benefits from your insurance company and you will be responsible for payment.
I authorize Bridgeway Recovery Center to keep my signature on file and to charge my credit card (held in our secure system) for:
Charges associated with payment arrangements.
Contact billing office to make payment arrangements.
I have read, understand, and agree to the above Bridgeway Recovery Center Payment Policy.
I understand that charges not covered by my insurance company, as well as applicable copayments and deductibles, are my responsibility. I acknowledge that these policies do not obligate Bridgeway Recovery Center to extend credit.
I authorize my insurance benefits be paid directly to Bridgeway Recovery Center.
I authorize Bridgeway Recovery Center to release pertinent medical information to my insurance company when requested, or to facilitate payment of a claim.