About insurance and billing
- What insurance plans do you accept?
- What about insurance company referrals?
- What about my insurance co-payment and deductible?
- What if I do not have health insurance coverage, or have a large deductible?
- What about medical bills?
- What about insurance claims?
- What if my medication is denied?
- What about billing problems?
- Workers Compensation and Auto Accidents
What insurance plans do you accept?
We accept the following insurance plans (current as of 1/18/2017):
- AETNA Including:
- Coventry Health Care (PPO Only)
- Community Care Network (CCN)
- First Health
- Mail Handlers
- Southern Health Services
- FELRA and UFCW
- Anthem Blue Cross/Blue Shield
- Carefirst Blue Cross/Blue Shield Including:
- Carefirst Administrators
- CHN/Community Health Network
- Choice Care: Health Systems International (Humana)
- CIGNA Including:
- Great West
- One Health
- Health Partners
- Medicare Replacement
- Medicaid: Only as a secondary
- Medicare (Novitas) Part B
- Mutual of Omaha
- Optima Health/Sentara: PPO/POS/HMO ONLY
- Signature Partners
- Tricare: Standard, Prime (Prime requires referral), Humana, ChampVA
- United Healthcare Including:
- Compass Rose
- Golden Rule
- MDIPA, Optimum Choice
- One Net PPO
We DO NOT accept the following insurance plans:
- Aetna Global
- Anthem Healthkeepers Plus
- CIGNA Connect Network
- Embassy Plans
- Kaiser Medicare
- One Net
- Signaure Parnters Medicare Advantage Plans
- United Health Care
- AARP/Medicare Complete
- All Savers
- Compass/Compass Balanced/Compass Plus
- Gated Plans
- Medicare Advanatage Plans
What about insurance company referrals
If your health plan requires an insurance referral for your visit with us, it is your responsibility to obtain this insurance referral prior to making your office visit or testing appointment. If you are required to have an insurance referral for an office visit or for testing, and you do not obtain the referral, you will be asked to sign a waiver for your care. You will then be personally responsible for the full charge for the office visit or testing, which must be paid at the time of service.
What about my insurance co-payment and deductible?
At all office visits you will need to provide us with your current insurance information. Please bring your insurance cards to all office visits. These will be copied at all visits. It is your responsibility to notify us when any insurance changes occur. Insurance companies and managed care plans have different co-payment and deductible requirements, which vary and often change without our knowledge. All patients, including those patients with Medicare coverage, are expected to meet their full co-payment and deductible requirements at the time of service. We will collect your co-payment prior to each visit. Your co-insurance and deductible should also be paid at the time of service.
Patients who do not pay their co-payments, co-insurance or deductibles at the time of each visit are charged an administrative fee, plus an additional administrative fee for each statement sent. These charges are not covered by your insurance company.
Please remember that insurance is considered a method of reimbursing the patient for fees paid to the doctor. It is not a substitute for payment. Some plans pay fixed allowances for certain procedures and others pay a percentage of the charge. Co-payment, co-insurance or deductible amounts are due at the time of service.
It is your responsibility to know the amount of the office co-payment, co-insurance and your deductible, and to promptly pay any co-pay, co-insurance, deductible or other charges not paid by your insurance company at the time of service.
Failure to pay co-payments, co-insurance, and deductibles at the time of service may result in dismissal from the practice.
What if I do not have health insurance coverage, or have a large deductible?
Patients without health insurance coverage (self-pay individuals), and those with large deductible insurance plans (such as with HSA accounts) will be required to provide valid credit card information prior to receiving services. A deposit may be required before services are provided.
What about medical bills?
Our fees are customary for our specialty and our locations. There is an initial consultation charge. Subsequent office visits and other services vary in charge, depending on the problem, time and services involved. Payment at the time of each visit is expected from all patients for all co-pays and deductibles and for all charges for which the patient is responsible. This helps control our charges for patient care. Payment may be made by cash, check, MasterCard, Visa or Discover.
All patients, including those with high deductible insurance plans (such as with Health Savings Accounts), those patients with coverage from a company with which we do not participate, automobile or other accidents, and those without insurance coverage, are expected to pay for all services at the time of the visit.
An administrative fee is charged for co-payments and deductibles not paid at the time of service, and an additional administrative fee is charged for each bill sent.
What about insurance claims?
We will submit insurance claims for office visits and testing if we have a contract and are a participating provider with your insurance carrier. We participate with Medicare and with many, but not all managed care plans. It is YOUR responsibility to determine whether we participate with your health care plan. If you have any questions as to whether we participate with your insurance plan, please contact our patient accounts office at 703-876-0813. A listing of the insurance plans we accept is available at the top of this page, or on our Patient Portal.
Although we will submit charges on your behalf to carriers with whom we participate, the ultimate responsibility for payment of all charges rests with you.
If we do not participate with your insurance plan, we will supply you with the necessary information for you to file with your own insurance company. For diagnostic testing performed in this office, we will file the insurance claims if you provide us with an insurance authorization form and pay any portion (co-payment, co-insurance or deductible) required by your insurance policy.
What if my medication is denied?
We understand that your insurance company has denied the medication, MRI/test, etc. prescribed by your doctor. Your doctor has already completed a prior authorization outlining your need for this therapy and its medical necessity. Your insurance company has denied this medication/test for you. We recommend that you now appeal directly to your insurance company to request this test/medication. You should also contact the HR department at your work to appeal.
Your personal appeal is now most important. We have provided some guidance about how to do an appeal on our website. If you still would like your doctor to write a letter of appeal on your behalf, there may be a fee of $25 for this service. It takes an average of 10 days for an appeal letter to be prepared.
What about billing problems?
If questions or problems arise regarding medical bills or insurance matters, please contact our Patient Accounts Office at (703) 876-0813 between 9:00 a.m. and 5:00 p.m. weekdays. Medical bills, especially after hospitalization, can be a source of confusion. We will be happy to help you obtain maximum insurance benefits. However the agreement by your insurance company to pay for medical care is a contract between you and your insurance company.
If unusual circumstances should make it impossible for you to meet your financial obligations, we invite you to call or personally discuss the matter with our patient accounts office at (703) 876-0813. Doing so will avoid misunderstandings and help keep your account in good standing. Overdue accounts will be pursued for collection and may be reported to the credit bureau.
We are a participating provider with Medicare. We are required by law to submit all Medicare claims. PATIENTS SHOULD NOT SUBMIT MEDICARE CLAIMS THEMSELVES, as such duplicate submissions are likely to cause confusion and delays in receiving reimbursement from Medicare. If you provide us with secondary insurance information, we will file a claim to that carrier for any remaining balance, after we receive your Medicare payment and Explanation of Benefits form.
Workers Compensation and Auto Accidents
We do not generally accept workers compensation cases or automobile accident cases for direct patient care. These are accepted for testing only patients.
If you have Workers’ Compensation coverage, it is your responsibility to provide our staff with written confirmation of coverage, so that we may obtain prior authorization for all services. No service can be provided without prior written authorization from your Workers’ Compensation carrier.
If your care is due to injuries sustained in an automobile accident, you are responsible for keeping your account current. Many insurance companies do not permit us to file for coverage under your health insurance plan when you have been involved in an accident.
The information provided by neurologycenteroffairfax.com is for informational purposes only. Do not rely on neurologycenteroffairfax.com or any site accessed through neurologycenteroffairfax.com for medical advice. The content on this site is not intended to be a substitute for professional medical advice, treatment, or diagnosis. Always consult your physician or other health care provider for any questions you may have regarding a medical condition, diagnosis, or treatment. If you have questions about your health, you should consult your personal physician. If you think you have a medical emergency, dial 911 immediately.