Insurance Policy

2540 W Arrowood Road

Suite 110

Charlotte, NC 28273

Tel: 704.588.9997

Insurance Policy

“In Network” vs. “Out Of Network” Insurance

Your insurance coverage and benefits are a contract between you (the insured) and your insurance company (the insurer) and, therefore all disputes must be handled between you and your insurance company.
We are contracted with multiple insurers to accept assignment of benefits.
If you have insurance coverage under a plan with which we do not have a contract, you will be treated as a “self pay” patient and will be provided with the necessary documentation to assist you in filing your own claim with your insurance carrier.
Unfortunately, we are not able to accommodate NEW patients on Saturdays due to our inability to verify eligibility with the insurance. However, if you are able to give us all the information we need and your eligibility is verified 48 hours prior to your Saturday appointment, we will be able work with you.
Established patients with new insurances are required to notify our office of their new insurance plan or of any changes to their current insurance plan 24-48 hours before their next visit.
We are required to file with your primary insurance carrier only. As a courtesy we will bill your secondary and tertiary insurance, if any. It is your responsibility to insure that they pay us within 2 months of the primary payment, or you will be expected to pay the remaining balance after your primary insurance pays.

Workers’ Compensation:

Upon Approval from your claim adjuster or case manager our office will send appropriate workers’ compensation claim forms for services rendered on your behalf as a courtesy to you. If and when a claim is denied, we will expect full payment from you within 15 days of receipt of our bill. We must have all appropriate information to properly file your claim.

Lab/Hospital Charges:

Any service(s) provided by a lab is a contract between you and that lab. Any dispute with that lab or hospital should be handled with that lab and is not the responsibility of Alfa Medical.
It is your responsibility to know which procedures your insurance plan will or will not cover at these facilities and to request an Explanation of Benefits (EOB) from your insurance carrier.

Collections and Outstanding Balances:

Each payment not received within 90 days of date of service will incur a $10 billing fee per month.
Payments not received within 120 days from the date of service will incur a 1½% interest rate (18% APR) for each month thereafter, and will be reported to the credit bureau for collection purposes.
Delinquent accounts will be sent to collections and patients with unpaid collection accounts will be discharged from our practice. There will be a $25.00 agency fee for all collection accounts.
If you have arranged for a payment plan prior to the 90 days, you will not be subject to the billing fees or interest rates.

Payment Plans:

Our office will be happy to work with you in order to pay any balance due to our practice.
Please contact our billing department to work out a payment plan with our practice.
Please allow 5 mailing days prior to each due date for each payment to be received by our practice.
Please mail all payments to our office Or you can make payments over the phone at:

Alfa Medical Clinic, PA

2540 W Arrowood Rd

Ste 110

Charlotte, NC 28273

(704) 588-9997

(704) 588-9499 (fax)

http://www.alfamedicalclinic.com/

Refunds:

Refunds are issued to the appropriate party.
Patient refunds will not be processed until all active or past due charges are paid in full.
Refunds less than $10.01 will not be issued, unless requested, but will be credited to your account at our practice.