Insurance Billing and Policies

MESSAGE TO OUR PATIENTS

Thank you for choosing California NeuroInstitute for your healthcare needs. We are all committed to enhancing the quality of your care and overall experience with us. Once way of achieving this is by establishing clear communication regarding our policies and clear expectations of compliance with them.

The following information is provided to help you understand how your insurance works, what your responsibilities are in relation to our financial policies and some of the reasons for them.

We encourage you to contact the front office with any questions you may have.

INSURANCE

We accept Medicare and most commercial insurances including many HMO’s and PPO’s.
​ We also accept Worker’s Compensation on a case by case basis.
Please contact our office directly if you have any insurance related concerns.
We also have competitive rates for cash pay patients who may be from out of the country.

BILLING

For any billing related questions, please contact our office directly at 408.540.6861

UNDERSTANDING YOUR INSURANCE AND FINANCIAL RESPONSIBILITY

Healthcare Information & Patient Responsibility

It is the patient’s responsibility to immediately communicate any changes in their healthcare information to the front office. Healthcare information includes the following:

-insurance information/coverage
-responsible financial party (ex: adjuster/attorney)
-address
-telephone number
-fax/email
-emergency contact
-change of referring and/or primary care physician
-any additional injury to same or different body part since last visit or referral

What to expect at each visit
Please note regardless of the status of your insurance, each time you arrive for your scheduled office visit, you will be expected to sign in and show your insurance card to the front desk before being seen by your provider.

Please contact the front desk if you have any questions or concerns. We are happy to assist you in any way we can.

Financial Policy
California NeuroInstitute has a 24-hour minimum cancellation notice policy

If you must cancel your appointment, please notify us promptly. We will do our best to reschedule at a time that is convenient for both you and your provider.

Payment is due at the time of service 
Deductibles, Co-Payment (co-pays) and Coinsurance must be paid at the time services are rendered. This arrangement is part of your contract with your insurance company. Faile on our part to collect co-pays and deductibles from patients can be considered an act of fraud on our part. Please provide your payments at each visit so we are not forced to refuse you our treatment services.

Late cancellations or “No Show” Fees
If you cancel less than 24 hours or fail to show up for an appointment, you will be charged a “missed appointment fee” which must be paid before rescheduling. You will be charged as follows:
Office visit – $100
Office Procedure – $200
Operating Room Procedure – $500
*additional charge may apply if medications are ordered and cannot be returned or stored

Service Fees
Late Pay: A fee equal to 10% of any late co-pay, coinsurance or deductible will be added to the payment and must be paid before or by the next scheduled appointment.
Returned checks: a service fee of $25 will be charged for a first-time returned check and $50 for all subsequent checks

Self-Pay Patients
Services provided are expected to be paid in full at each visit

Dismissed from Practice
After three missed appointments, you risk being dismissed from the practice. You will not be permitted to reschedule without approval from management and Dr Khan. 

TERMS AND DEFINITIONS

Deductible: a deductible is the initial amount of money an insured has to pay (out-of-pocket) before any benefits from the health insurance policy can be used. Most deductibles renew on an annual basis and begin in January with services covered during the calendar year. However, there are others that renew mid-year in July. Some insurance carriers allow for a “last quarter carry-over” whereby the services during the last quarter of the year can be carried over and applied to the next year’s deductible. If you are unsure which you have, contact your insurance agent. 

Co-Payment: a co-payment is a fixed amount you are required to pay for each medical service you receive, regardless of the cost of the service. Unlike a deductible that’s usually paid once a year, a co-pay is paid each time a healthcare service is used. 

Co-insurance: unlike the fixed amount of a co-pay, coinsurance is a percentage of the provider’s cost of service after the deductible has been met. Co-insurance continues to be paid until you reach your “out-of-pocket” maximum. After that, the insurance company will pay for all covered services up to the policy’s maximum, for the remainder of the year. Out-of-pocket maximums have a wide range of possibilities depending on the insurance – from $1000 to $5000 or more. 

Out-of-network: A provider who has not contracted with your insurance company for reimbursement at a negotiated rate is referred to as an “out-of-network” provider. 

Some health plans (example, HMO) do not reimburse out-of-network providers at all, which means that as the patient, you would be responsible for the full amount charged by your provider. 

Other health plans offer coverage for out-of-network providers, but your patient responsibilities would likely be higher than it would be if you were seeing an in-network provider. 

Call Today

408.540.6861

2512 Samaritan Court, Ste H San Jose CA 95124