Payment Options - Surgical Specialists PA
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Payment Options

payments3Practice Credit Policy and Privacy Information Policy
We at Surgical Specialists want to insure that our patients’ health not be compromised or neglected by a harsh or inflexible credit policy. We strive to have a uniform, fair, and consistent procedure for handling of all patient accounts, which encourages the prompt payment of all medical debts through reasonable and effective procedures and follow-up.

If your insurance requires a co-payment, you will be required to pay this at the time of your visit.

We accept cash, checks, debit and credit cards for payment.

Uninsured Patients
Surgical Specialists, P.A. does not deny care to patients who find themselves without insurance. All uninsured patients will be required to sign a Patient Payment Agreement before they leave from their first office visit. Uninsured patients may be eligible for an adjusted rate if payment for services rendered is received before the actual service, or on the date of service.

Insurance Claims
Insurance claims will be filed for patient providing appropriate demographic and insurance information. We will file with as many as three insurance companies on behalf of the patient. Copies of the insurance card(s) will be placed in the chart.

If patient is filing under workers compensation, the patient is responsible for providing all information necessary to file for workers compensation.

Monthly Statements
All patients will receive a monthly statement informing them of the patient balance and the balance pending with the insurance company (if insured) unless using payment vouchers. *see below*

Patients will be allowed 90 days from the date of patient responsibility to pay off the account balance. If the patient determines that it is not possible to pay the entire account balance within 90 days, reasonable monthly payments will be considered. A payment plan can be set up through our accounts department. If payment has not been received within 90 days, we will begin taking steps to send the account to collections.

Payment Vouchers
Payment vouchers will be issued upon signing the patient payment agreement. Current balance will be noted in the vouchers, therefore monthly statements will not be sent unless requested by the patient.

If a patient feels that they have extenuating circumstances that prevent them from paying a portion or their entire bill, they may fill out a “Request for Waiver of Payment Due to Economic Hardship” form. This form is to be filled out and brought back to us with the required proof. We will review each request and the patient will be notified as to our decision regarding their situation. Filling out a request form does not guarantee that part or all of your outstanding balance will be waived. A new request form and hardship documentation must be obtained and submitted for each occurrence.

Lack of Cooperation
Surgical Specialists, P.A. believes that all patients should be treated with dignity regardless of their ability to pay.

Surgical Specialists, P.A. reserves the right to terminate a patient from the practice in those rare cases when a patient may be verbally or physically abusive, refuses to give necessary information, or is non-compliant with medical advice.