Insurance information
Common Questions & Policies
Billing/Payments/Insurance Details
Your insurance coverage is a contract between you and your insurance company.
- We are not a party to that contract.
- Our fees generally fall within the range allowed by most companies and, therefore, are covered up to the maximum allowance determined by each carrier. To verify your coverage, this office will contact your insurance company. This does not guarantee payment of services.
- Not all services are covered benefits in all contracts. It is your responsibility to learn from your insurance company what it will or will not cover under your contract. We must emphasize: our relationship is with YOU not your insurance company. While the filing of insurance claims is a courtesy, which this office extends to the patients, all charges are your responsibility; and it must be paid within thirty (30) days from the time services are rendered.
- Idaho Medicaid
- True Blue
- Blue Cross
- BPA/Select Health
- IPN Insurance Plans
- Tricare
- Various Other Insurance Plans
We also have low cost self-pay options available. Call for details!
We accept most standard payment methods.
208-333-9578
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan.
Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.
APPOINTMENTS/PRESCRIPTIONS:
We make every effort to allow ample time for every patient, as quality of care is very important. It will be your responsibility to contact this office 24 hours in advance if you are not able to keep your appointment.
Appointments that are not cancelled 24 hours before the appointment time may incur a charge of $50.00.
Telephone contact with the provider matching and/or exceeding the allotted duration or resulting in changes in medications may incur a charge of $35.00. Requests for prescriptions of controlled medications outside an appointment with you provider may incur a charge of $10.00.
As a courtesy, this office will verify your appointments one day before using the telephone numbers you have provided. However, keeping your scheduled appointments is your responsibility. Because we want to provide you with the utmost privacy regarding your visits, please be sure you provide us with phone numbers where we may leave a message regarding your appointment if you are unavailable.
No Suprises Act (NSA) Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider,
you may owe certain out-of-pocket costs, such as a
copayment, coinsurance, and/or a deductible. You
may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.
- If you believe you’ve been wrongly billed, you
may contact:
The U.S. Centers for Medicare & Medicaid
Services (CMS) at 1-800-MEDICARE (1-
800-633-4227) or
visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
If you have an emergency medical condition and get
emergency services from an out-of-network provider
or facility, the most the provider or facility may bill you
is your plan’s in-network cost-sharing amount (such
as copayments and coinsurance). You can’t be
balance billed for these emergency services. This
includes services you may get after you’re in stable
condition, unless you give written consent and give up
your protections not to be balanced billed for these
post-stabilization services.
PAYMENTS:
This office will file claims to the patient’s primary
insurance company only for reimbursement, but the patient will be responsible for making the required co- payment at the time of service. For self-pay patients, full payment is expected at the time of service. We accept cash, cashier’s checks, certified checks, personal checks, credit/debit cards and money orders. If your payment is returned because of insufficient funds, a charge of 20.00 will be added to your account. We will not release your records to other providers if you have an outstanding balance.
Your account needs to be kept current unless other arrangements have been made.
- Good Faith Estimate You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical
items and services. - You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital
fees. - Make sure your healthcare provider gives you a Good Faith Estimate in writing at least
one business day before your medical service or item. You can also ask your healthcare provider, and any other provider
you choose, for a Good Faith Estimate before you schedule an item or service. - If you receive a bill that is at least $400 more than your Good Faith Estimate, you can
dispute the bill. - Make sure to save a copy or picture of your Good Faith Estimate.
