This financial policy contains important information about billing and payment for our professional services. It is intended
to help ensure the best possible medical care for our patients, while also controlling administrative costs. It outlines our
responsibilities, and those of our patients, with regard to billing and payment for our services.
- Our practice participates with many health insurance companies and managed care programs. Our business office will
submit a claim for any services rendered to a patient who is a member of one of these plans. Patients must provide all
necessary insurance information and complete any required forms before leaving the office. - If a patient is a member of an insurance plan with which we do not participate, our office will also file the claim on the
patient’s behalf; however, the patient is expected to make payment in full at the time of service. - It is the patient’s responsibility to make payment at the time of service for any co-payment or co-insurance due. Any
services not covered by a patient’s insurance plan are the patient’s responsibility and payment in full is expected at
the time of service. Failure to make a co-payment on the day of service will result in an administrative charge of $25 in
addition to the co-payment. - Payment for professional services can be made by cash, check, credit card or debit card. We accept VISA®,
MasterCard®, American Express® and Discover® Card. You may also pay online at www.communitycare.com — click the
link on menu at the very top of the homepage that says Pay My Bill. Please note, to pay your bill online you will need
the unique bill payer ID from your most recent invoice. - Community Care Physicians charges a fee of $35 for each check returned for insufficient funds.
- It is the patient’s responsibility to ensure that any required authorization or referral for treatment is provided prior to
the visit. In the absence of a required authorization or referral, the patient’s visit may be rescheduled or the patient may
be personally responsible for payment for the services rendered by Community Care Physicians. - It is the patient’s responsibility to provide us with current insurance information and to present an active insurance card
at each visit. - Our staff is happy to help with insurance questions relating to a claim that has been filed, or to provide additional
information required by the insurance carrier to process the claim. However, patients should direct questions about
coverage for specific procedures to a representative of their insurance company’s member services department. The
phone number for member services is usually on the insurance card. - An adult accompanying a child under 18, and/or the parent or guardian of the child, is responsible for payment
according to the terms described above. Non-emergency treatment for children unaccompanied by an adult may
be rescheduled by Community Care Physicians unless charges have been pre-authorized, or payment by credit card,
debit card, cash or check at time of service has been arranged. - If a patient requires the completion of medical forms at a time other than an office visit, each form will be subject to an
administrative fee of $25. - Please understand that when a patient does not cancel an appointment he or she is unable to keep, it may prevent
other patients from receiving care they need. Therefore, Community Care Physicians charges a fee of $50 for
appointments not cancelled with at least 24 hours’ notice for a primary care appointment and a fee of $200 for a
specialty care appointment not cancelled with at least 24 hours’ notice. This fee is subject to change. A patient who
fails to keep three or more appointments in a twelve-month period—without prior notice of cancellation—may be
discharged from Community Care Physicians at the discretion of the patient’s physician.
In the event of personal financial hardship, Community Care Physicians is able to offer special financial arrangements,
including payment plans.
We firmly believe that effective communication is the key to a successful physician-patient relationship, and we are eager
to help in any way we can.