OUR FINANCIAL POLICY

We are committed to your successful treatment without additional worry about your financial obligations. The following is a statement of our financial policy, which we ask that you read and sign prior to any visit in our practice.

Financial Obligations

​

General Clauses:
It is your responsibility to determine if Onyx Aesthetics and Sports Medicine (Onyx Direct Care LLC) and their treating physician(s) participates with your insurance(s).

You should have a basic understanding of how your insurance works.

If we participate with your plan, and if your plan offers coverage/benefits for a procedure/service, our office will bill your account up to the maximum allowable negotiated fee as determined by your insurance company.

If your service is a covered benefit under your plan, the insurance company may pay all or only a percentage of that reduced/negotiated maximum allowable cost, and you are responsible for the remaining percentage/difference. All copays are due at the time of your visit.

Insurance is a contract between you (the patient) and your insurance company itself; If we happen to be in-network with your insurance plan, it does not mean that we happen to know the details of the benefit package you signed up for.

While our office can provide an estimate of any co-pay, this is not a guarantee that your insurance will cover the remainder of the bill for your treatment. It is your responsibility to know your insurance percentage coverage, co-pays and out of pocket costs. Whatever percentage of coverage you are responsible for (and thus any out-of-pocket costs towards that maximum allowable amount) is between you and the insurance company, based on the plan that you selected. Please understand that “participating” with medical insurance plan (being In- Network) means only that your doctor has agreed to a negotiated and reduced fee for certain, and not necessarily all, services that we provide.

It is your responsibility to advise our office of any insurance payments or explanations of benefits (EOBs) you receive regarding your treatment. Please be aware that some, or perhaps all, of the services provided may be non-covered services under your particular insurance contract, or may not be considered reasonable and necessary under your plan. In those cases, you will be responsible for the non-reduced fee (our regular office fee schedule amount). Please be advised that if your doctor does not participate with your insurance carrier, you will be required to pay in full for any services rendered on the day of treatment, as determined by our regular office fee schedule. We will submit all claims and proper paperwork to your insurance company on your behalf, and your insurance company will usually send payment directly to you.

If your insurance requires your treatment and claims to be submitted to your medical insurer before they consider the claim, we will submit all necessary information on your behalf and apply any payments toward your outstanding balance.

​

If you do not have insurance:
Patients without insurance are responsible for the full cost of treatment, as determined by our regular office fee schedule. Patients with participating medical insurances (“In-Network”) shall pay the amount of their estimated co-pay and deductible as determined by their plan’s maximum allowable fee schedule at the time of service. In addition, payments for our services are now possible through CareCredit- CLICK HERE FOR MORE INFORMATION.

​

Other:
All patient balances must be settled within 90 days of the date services are rendered. This is regardless of whether or not your insurance claim is in progress, pended, or finalized. If your insurance has not paid their obligated percentage of your balance within that 90 day period, you will need to pay the remaining balance to our office and await reimbursement. (see below). After 90 days the patient is responsible to pursue payment from the insurance company. We will
assist you with this in any way we can. All current documentation can will be provided by mail or email in order to assist any inquiries. Any insurance reimbursements paid to us (after your bill is paid in full) will be remitted to you within 30 days of receipt by us.

​

Patient Acknowledgements:
Patients are responsible for the payment of their own account. You may designate insurance coverage through another person if you are a participant under his or her plan; however, you should understand that all financial responsibility remains with the patient. Minors are unable to enter contractual agreements for their care and must be accompanied by a legal guardian, who shall assume the financial responsibility for the underage patient. It is your responsibility to notify our office of change or loss-of-coverage with insurance, or any change to your billing address or the address where you wish to receive our correspondence. Any charge not paid by your insurance because of incorrect primary insurance information, failure to submit proper insurance in a timely manner or coordination of benefits issues not handled with your carrier will be the financial responsibility of the patient. We are not responsible if your insurance company decides any treatment does not qualify as a covered benefit due to deductibles, depletion of yearly funds/benefits, or any other plan provisions. These factors are determined by the insurance company and the particular plan you (or your group) selected. You understand that the treatment recommended by our office is never based on what your insurance will pay. Rather, treatment is determined by the health and needs of each patient and his/her condition.

​

Payment Plans & Options:
We accept cash, check, debit, credit, as well as payments made through 3rd party providers such as Care Credit. All credit card payments and electronic transactions will incur a 4% surcharge; this does not apply to cash, debit card, or checks.

​

Service Fees, Counsel Fees, and Costs of Collection:
Any balances left on your account over 90 days after your insurance company has satisfied all claims will incur a 1.5% service charge every month (18% per year) until the balance is paid in full. If your account is outstanding for more than 90 days, it will be considered delinquent, and may be sent to, processed, and managed by a collection agency or attorney for collection. In such case, you agree to be responsible to pay all additional collection fees, counsel fees, court fees or associated costs. Collection fees will be at least equal to 35% of the amount of your outstanding balance, inclusive of interest. Interest will continue to accrue on your outstanding balance until your account is paid in full. Once your account is sent to collections, we are not able to waive any fees or penalties associated with your account.

​

Insufficient Funds with Checks (Returned/”bounced” checks): A $50.00 fee will be applied for any returned checks.

​

Permission to Submit Insurance Claims on Your Behalf:
Onyx Aesthetics and Sports Medicine (Onyx Direct Care LLC) will require your permission to submit any and all insurance claims on your behalf by either postal service or electronically. You also grant permission for Onyx Aesthetics and Sports Medicine (Onyx Direct Care LLC) to submit any letters or disputes to the insurance commissioner’s office, in an effort to collect maximum payment from my insurance companies for services rendered by Onyx Aesthetics and Sports Medicine (Onyx Direct Care LLC) and their treating physician(s).