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Billing Policy

Our Billing Policy

Thank you for choosing Urology Associates, P.C. as your healthcare provider. Our providers and staff are committed to delivering service, compassion and quality care to you. Understanding our Financial Policy is an important part of our professional relationship.

Financial Policy

Your insurance co-payment* is due at the time of your visit. If you are unable to pay your co-payment at the time of your visit, we will reschedule your visit. If we determine you have a deductible* or co-insurance* amount due, you will be asked to pay this amount at the time of your visit.

If you are required to obtain a referral from your primary care physician in order to see an urologist, it is your responsibility to bring this with you to your visit. If you do not have a referral, we will reschedule your visit so you can obtain one.

Urology Associates will assist in obtaining pre-certification from insurance plans if required. However, insurances vary in coverage, and it is the patient’s responsibility to understand medical benefits and requirements. We recommend that the patient verifies insurance benefits for any procedures, tests or services scheduled.

It is your responsibility to know if we participate with your insurance plan. If your insurance company is out of network with us, you will be responsible for payment in full at the time of service.

You will be responsible for 100% of your total out of pocket* responsibility amount prior to any procedures, testing, or services.

For self-pay patients, a payment of $150.00 is due at check-in. A credit card must be kept on file for the remaining balance, which is to be paid in full at check-out. A non-refundable deposit of $50 is required at the time of scheduling an appointment and will be applied to the visit cost. Cancellations must be made with at least 24 hours’ notice. If you cancel more than 24 hours in advance, the deposit can be transferred to a rescheduled appointment one time only. Cancellations made with less than 24 hours’ notice or noshows will result in the forfeiture of the deposit. Frequent no-shows or rescheduling may lead to restrictions on future appointments or require full prepayment.

We do our best to estimate your financial responsibility up front, but please understand this is only an estimate. Due to the specialty of our practice we do not bill Well Visit Exams to insurance.

 

Cancellation / No-Show / Reschedule Policy

In order to provide the best care and service to our patients, we ask that you notify us 24 hours in advance to cancel and/or reschedule your office appointment. If you forget or fail to show up for the appointment, there will be a $50.00 fee charged to your account.

Cancellation of a scheduled procedure, surgery or diagnostic imaging requires 72 hours’ notice. Any cancellation not made 72 hours in advance will be subject to a fee of $150.00.

Cancellation of a scheduled PET CT scan requires 72 hours’ notice. Any cancellation not made 72 hours in advance will be subject to a fee of $500.

A $150.00 deposit is required at the time of scheduling a Vasectomy. The deposit will apply to the balance of your procedure. Cancellation of a scheduled Vasectomy requires 72 hours’ notice. Any cancellation not made 72 hours in advance will result in forfeiture of the $150.00 deposit, and you will be required to pay an additional deposit at the time of rescheduling.

A reschedule fee of $75.00 will be charged each time a procedure or surgery appointment is rescheduled.

The Cancellation/No-Show/Reschedule fees will not be billed to insurance.

Helpful Definitions

  • Out-of-pocket: Costs you have to pay yourself

  • Co-payment (or copay): Fixed amount you pay at each visit for services such as an office visit. (You pay your copay at the time of service, even if you have met your deductible, until you meet your out-of-pocket maximum.)

  • Deductible: The yearly amount you must pay before your insurance begins to pay.

  • Coinsurance: The percentage you pay for care even after your deductible is paid in full.

  • Out-of-Pocket Maximum: The most money you will pay in one year for all covered services. This usually includes all out-of-pocket costs: co-payments, deductible, and coinsurance.

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