Insurance

Insurance

Family Foot Care Clinic is on the same page with our patients when it comes to insurance.  We  are working hard to make sure your insurance carrier processes your claims correctly.

We cannot express strongly enough our recommendation that you speak with your insurance company prior to treatment so you can be certain that you understand and can comply with all of the requirements of your insurance company.  REMEMBER:  YOU are the insured; we are your health care provider.  This is YOUR responsibility!

 Questions to ask your Insurance Carrier

What podiatry treatments or services are not covered under my insurance policy?  Although podiatry may be a covered benefit under your policy, not all services may be considered a “covered benefit”.  For example, orthotics and routine foot care (trimming of nails or calluses) are frequently considered not medically necessary and, therefore, NOT a covered benefit.

~              Do I need a referral for treatment?  YOU are responsible for obtaining any/all referrals required by your insurance carrier prior to any visits.

~              Is Dr. Neuhoff  a participating provider in my network?  You can give our tax ID# 35-1924241 to your insurance carrier when asking if we are considered in network or not.

~              Is pre-certification or prior authorization required for any medical or surgical procedures?

 

Commonly Used Insurance Terms

 Who is this?

Beneficiary:  This is the person covered by an insurance plan and receives benefits as such.

Provider:  This is the person or facility that provides healthcare to a patient.

Subscriber/Policyholder:  This is the person that qualifies for insurance coverage, either through his/her employer or through a privately purchased policy.

 

Primary Care Physician (PCP)

This is your family doctor.  If your insurance has indicated you have a PCP (doctor’s name will appear on your insurance card), your visit to one of our podiatrists may NOT be covered by your insurance company unless you have been referred by your family doctor (PCP).  Most often the referral is on a form, a copy of which must be received by our office PRIOR to your visit with  Dr. Neuhoff.  It is the responsibility of each patient to obtain any/all necessary referrals.  If your insurance company requires referrals, and one has not been done, your claim will be denied and YOU will be responsible for all charges incurred IN FULL.

 

Policy Numbers

Because of the HIPAA (Health Insurance Portability and Accountability Act), many insurance companies are no longer using the social security number of the policyholder as the “policy number”.  Some insurance carriers do not even list a  policy number on the id card, simply stating that it is the subscriber’s SSN.  Due to these changes, we MUST have the following information on file:

  • Subscriber’s name, date of birth, social security number
  • Subscriber’s employer legal name
  • Policy number if other than the subscriber’s SSN and group number
  • A copy of the front and back of each insurance id card

 

Co-pay, Co-insurance, and Deductible

 

This is the patient responsibility portion of a covered charge.  If you have a secondary insurance plan, this may pay on these expenses.  Please be sure to let us know if you have two (or more) insurance plans that cover your medical expenses.  Co-pays are collected by our front desk staff at the time of service.  Please come prepared to pay this at each visit.

 

Explanation of Benefits (EOB)

 

This is an important document that your insurance company sends to you and to your healthcare provider.  The patient usually receives their EOB 7-10 days before the healthcare provider will receive one.  If you do not understand how your insurance claim was processed, please contact your insurance company by calling the “800” number listed on the EOB.

 

Assignment

 

This is an insurance term telling where the insurance company will send payment for services rendered.  Assigned means the check will be sent to Family Foot Care Clinic; unassigned means that the check will be sent to the patient.