Financial Policy

Understanding The Financial Aspects of Your Health Care

The office of Moreland OB-GYN Associates, S.C. has developed a patient-friendly system for billing and payment tracking. We offer this Patient Friendly Guide to help you better understand what to expect when you receive services from us. Our Business Office is available to answer any questions you may have.

Financial Policy Statement

All patient balances are due at the time of service, this would include the following:

Copayments – A dollar amount your insurance plan requires you to pay before a visit or specified service.

Deductible – The amount of money you must pay (up front) before covered benefits are applied and paid.

Co-insurance – Indicates how you and your plan will share the cost of your expenses that exceeds the plan’s deductible. Co-Insurance is expressed as a set of percentages, generally with the insurance company’s portion stated first. The insurance plan applies Co-Insurance until the maximum out-of-pocket expenses are incurred. Once this threshold is met, the insurance plan will assume 100% of the responsibility.

Any balances previously incurred

A Financial Counselor can meet with you to set up a specific payment arrangement for any self-pay responsibility.  If interested, please inform a Moreland OB-GYN associate if you desire a meeting.

Medical Insurance Requirements

When you schedule an appointment at Moreland OB-GYN Associates, S.C., you will be asked for specific insurance information. Please have your insurance card available during this time. Bring your insurance card with you the day of your appointment.

We encourage you to become familiar with your health insurance plan. Each carrier has specific rules regarding coverage and benefits. It is your responsibility to understand them. If you have any benefit or coverage questions, please contact your insurance company directly. Many insurance plans have limitations to coverage and benefits, which can result in a balance that you would be responsible for.

Moreland OB-GYN Associates, S.C. providers participate in most major insurance plans. Check with your insurance company to see if Moreland OB-GYN doctors are covered under your plan.

Filing Insurance Claims

As a courtesy to our patients, our office will file insurance claims on your behalf. To avoid delays or denials to your claim, please make sure your insurance carrier has the correct personal information needed to process your claim. If your insurance changes, please notify us as soon as possible so we can make the appropriate changes and optimize your benefit plan, if your insurance company does not pay your claim in 90 days, you will be billed for the balance. Again, remember you are ultimately responsible for payment of the services you incur.

Financial Assistance Programs

If you qualify for financial hardship, your obligation with us may be discounted or in some instances, forgiven. You will be asked to provide certain financial information, which will help determine your ability to pay. The amount of discount you receive will depend upon your adjusted income as compared with the U.S. Department of Health & Human Services Poverty Guidelines.

Not Showing for an Appointment

Our goal is provide quality individualized medical care.  No-shows inconvenience those individuals who need access to medical care in a timely manner. We would like to remind our patients of this policy that enables us to better utilize available appointments for our patients in need of medical care.

To assist, Moreland OB-GYN Associates does perform appointment confirmation calls two days in advance, serving as an appointment reminder and giving patients an opportunity to adjust the appointment, if needed.

Missed/No Show Appointments
We understand that occasional missed appointments can occur for a variety of reasons.  A no-show is defined as missing an appointment without cancelling, where no prior notice was given that you were not going to be able to make your scheduled appointment (preferably a minimum of 24 hours in advance).

No Show Appointment Fee
Office Appointments- which are not cancelled in advance will be subject to a twenty five dollar ($25.00) no show fee.

Diagnostic Appointments- (i.e. ultrasound, bone density) which are not cancelled in advance will be subject to a fifty dollar ($50.00) now show fee.

Procedure Appointments- (i.e. IUD insertion, fertility, colposcopy, ablation) which are not cancelled in advance will be subject to a fifty dollar ($50.00) now show fee.

Moreland OB-GYN Associates firmly believes that a good physician/patient relationship is based upon understanding and good communication.

 

Preauthorization or Precertification and Second Opinions

Insurance coverage requirements vary widely. For instance, many insurance companies require an approach called “Preauthorization” or “Precertification” before your provider performs certain tests or procedures. Your insurance company may also require a second opinion before it will pay for certain surgical procedures. It is important to understand these requirements. Please contact your insurance company if you have questions about this. You are responsible for knowing if your policy requires preauthorization or precertification. If preauthorization is necessary, appropriate paperwork will be submitted as a courtesy, however, we are not responsible for the final determination. You will be responsible to pay for any services not authorized or denied by your insurance company. Also note that if an authorization is approved, it does not guarantee that benefits will be paid, Insurance companies always reserve this right to render a final determination.

Patient Billing

Any balance that exists after insurance has paid or has not been pre-paid by you will be billed back to you. If you are unable to pay the balance in full, please contact our business office to discuss reasonable payment arrangements. If there is failure to pay, your account will be referred to a collection agency and you would be placed on “Cash Only” status. If you are on a “Cash Only” status you must pay for any future services in full and before the date of your appointment, You may pay your bills by check, cash, cashier’s check, or money order. We also accept Master Card, Visa and Discover credit cards.

Self-Pay Patients (No Insurance)

If you do not have insurance, you will be expected to pay for routine visits in full prior to services being rendered. If you are unable to pay at the time of your visit, your appointment will be cancelled and rescheduled at a time when payment can be made.

Attention All BadgerCare Patients

We are currently contracted with every HMO except Managed Health Care and Network Health.

Contact Us

Phone: 262-544-4411
Fax: 262-650-3856

Moreland OB-GYN Associates, S.C. now offers nine locations to serve your needs. Visit us in Waukesha, Mukwonago, Sussex, Brookfield & Hartland.

Moreland OB/GYN-Lake Country offers three locations in Delafield, Oconomowoc & Watertown.

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