Insurance and Upfront Payment

Insurance Coverage:

Please provide us with your current insurance information at the time of your appointment. If your insurance changes, notify us immediately. We will bill your insurance company directly.

We will do our best to help you understand how insurance billing works but you are responsible for understanding your insurance benefits, including co-pays, deductibles, coinsurance amounts, and plan coverage limitations. 

Co-pays:

Any co-payments (co-pays) are due at the time of service. This payment is required by your insurance company and cannot be waived by our practice.

Self-Pay:

If you do not have insurance or do not wish to use your insurance, payment is due at the time of service. We offer a self-pay discount which covers any services provided during your visits such as doctor evaluation, counseling, and preventive screenings. 

High Deductible Plans:

Patients with high deductible insurance plans are required to pay an estimated portion of the visit cost at the time of service. 

Estimated Patient Responsibility:

All patients who use insurance at booking are charged the estimated patient responsibility which considers the available copay, deductible, and plan information.  

Billing Statements and Payment Methods 

Statements:

After your insurance processes the claim, you will receive a billing statement for any remaining balance by email. We will send the statement to the email address you provided at registration. Payment is due within 30 days of receiving the first statement email. 

Payment Methods: 

We accept all major credit and debit cards. Payments can be made using the payment links sent via email when we send your statement. We accept HSA and FSA cards for payments for visits. The monthly or yearly membership fees are not HSA and FSA eligible. 

Payment Plans:

If you are unable to pay the remaining balance on your account, please contact our billing department at info@plushcare.com to discuss payment plan options. 

Outstanding Balances and Financial Assistance

Balances Overdue: 

If you have outstanding balances, you may be required to pay your balance in full before scheduling future appointments unless a payment plan is in place. 

Financial Hardship Assistance: 

We understand that medical expenses can be burdensome. If you are experiencing financial hardship, please contact our billing department at info@plushcare.com to discuss potential assistance options and payment plans.  

Insurance Claim Handling

Denials: 
If your insurance denies a claim, we will notify you. It is your responsibility to resolve any coverage issues with your insurance company. We can assist by providing necessary documentation. Ultimately, you are responsible for paying any denied claims. 

Appeals: 
Should you wish to appeal a denial or if you have any questions or concerns, please contact our billing department at info@plushcare.com.