Health Plan Benefits
We encourage you to review your coverage prior to your visit. It is important for you to understand the extent of your health insurance coverage and the responsibilities you have as part of that coverage. Please review your member handbook or contact your member services department for any questions.
Credit Card On File Policy
Buffalo Lake Medical is committed to reducing waste and inefficiency and making our billing process as simple and easy as possible. We require that you provide a credit card on file with our office. We run our payments through our HIPAA-compliant, secure software. When you come in, we will scan your card with a card reader. Your payment information is stored on secure servers for future transactions. Office personnel will not have access to your card. For your protection, only the last 4 digits of your card will show in our system.
Credit Cards on File will be used to pay account balances after insurance adjudication.
Once your insurance has processed your claims, they will send an Explanation of Benefits (EOB) to both you and our office showing what your total patient responsibility is. You typically receive the EOB before we do, so if you disagree with the patient responsibility amount owed, it is your responsibility to contact your insurance carrier immediately.
When we receive the EOB, we will enter this information into our system. On the next Friday, if your total amount owed is $100 or less, we will process the payment on your card on file. If it is over $100, we will send out a statement showing your total responsibility. If you wish to give a different method of payment than the card on file or if you would like to split your balance into multiple payments, call our office to make arrangements.
Two weeks later (on Friday), we will run the statement amount on the card on file (unless other arrangements have been made).
If your payment is declined, we will call you to let you know on the next Monday.
If we receive no response by the next Friday, a $35 declined payment fee will be applied and a warning letter sent.
In 10 days, if we receive no response, your account will be sent to collections.
During the time you leave a credit card on file, if it expires or otherwise becomes uncollectable, we will expect you to promptly provide a new means of payment.
Credits on your account after your insurance claim has been adjusted will be returned to the credit card on file.
Should your credit card be mistakenly run, we will immediately issue a refund.
Ultimately, you are responsible for knowing what services are covered, how often, and how much of the cost is your responsibility. You will be responsible for any portion of services that your insurance does not cover.
Co-Payments/Co-insurance and Deductibles
Most insurance plans have co-pays associated with their coverage. Through our contract with your insurer, we are required to collect payment of deductibles and co-pays for services at the time services are rendered.
Billing and Statements
As a courtesy to our patients, we will file your insurance claim for treatment by our office to the insurance plan you have provided to us. For us to provide this service, we must have complete information on file. After the claim has been reviewed by your insurance plan, we will send you a statement for the amount which the plan has indicated is your responsibility. The balance showing on the statement is due within 30 days of the date on the statement. If you cannot pay your balance, please contact our billing department.
Buffalo Lake Medical participates with the insurance plans which follow. Please check with your insurance plan prior to your visit to our office to confirm our participation with your plan.
Blue Cross Blue Shield
All refunds will be made in check form, notwithstanding the initial payment type at time of service. The patient accepts full responsibility for reporting any refunded monies that were originally charged against a flexible spending account (FSA) or health savings account (HSA) to the respective parties managing those accounts.
If your insurance is not listed, we will submit the charges to your insurance with the understanding that the claim may be processed under out of network benefits.
Over-Payment Refund Policy
In the event of an overpayment on a patient's account (as determined by the insurance carrier or as a result of patient payment), a refund check will be issued. The refund will be issued to either the patient, or in the case of a minor patient, to the individual who signed as the financially responsible party on the financial statement for the visit for which the overpayment exists. A check in the amount of the overpayment, will be mailed to the address listed on the registration form or, in the case of a minor patient, to the address provided by the financially responsible party at the time of the minor patient's visit.
Refund checks will be processed approximately 60 days from either:
1. The final settlement date with the insurance carrier which caused the overpayment to exist on the account; or
2. The posting date in which the patient payment caused the overpayment to exist on the account.
No refunds are released until all the patient's outstanding claims have been processed by the patient's insurance company. Any overpayment by the patient's insurance company will not be processed and released to the patient unless Buffalo Lake Medical is instructed by the insurance company to release said funds directly to the patient.