Integrative Family Medicine
Financial Policy

Thank you for choosing Integrative Family Medicine for your healthcare needs. Please note that all patients must sign an Financial Policy form to ensure that patients understand and agree to the financial policies of our practice. You may download and print this form, read and sign it, and bring it to your first appointment. If you have any questions or concerns, do not hesitate to call our office at 856-869-3126.

Following is a summary of our policies:

Insurance
If you use health insurance, it is a contract between you and your insurance carrier. It is your responsibility to know the terms contained in your policy regarding coverage, co-pays, co-insurance, deductibles and non-covered services. If you have any questions about your insurance, you will need to contact your carrier directly. Current insurance cards must be presented once per year and whenever there is a change of information.

Referrals
If a referral is required by your plan for a specialist or diagnostic test, be sure to ask us for it a minimum of 48 business hours before your appointment. You need to provide us with the provider's name, provider ID #, fax #, location and reason for the appointment.

Pre-authorizations
A minimum of 72 business hours is required in order for our office to obtain pre-certifications. Our office will not pre-certify out-of-network diagnostic services. (Insurance companies simply deny these requests consistently.)

Co-Pays
All co-pays are due at the time of service, or a $10 charge will be added to your balance.

Supplements
All supplement sales are final – no returns. Please keep receipts after each purchase if you need to track out-of-pocket expenses for tax reasons. There is a charge of $10 for purchase summaries.

Outstanding Balances
If your account has an outstanding balance, you will be expected to pay or make payment arrangements before seeing the doctor. We accept cash, personal checks, MasterCard and Visa. If you have questions about your statement, please first call our outside billing agency Express Claims at 866-506-2344.

Self-Pays
All self-pay visits must be paid at the time of your visit. If you keep track of out-of-pocket expenses for tax purposes or Flexible Spending accounts, please be sure to request a receipt/superbill at every visit/purchase.

Missed Appointments
There is a missed appointment charge of $35 assessed if you do not provide 24 hours notice.

Refills
24 business hours must be given for all refills. Please call before you are out of medicine. Prior authorizations for medications take a minimum of 72 hours.

Motor Vehicle Claims
We will not bill your motor vehicle insurance company if you do not have a copy of your motor vehicle insurance card, claim # and a contact name at your automobile insurance company. Motor vehicle claims must be paid in full at the time of service if this information is not available at the time of your visit.

Miscellaneous Fees:

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