By “accepting” your insurance, we agree to submit your claim to your insurance company for you, this is not the same as "participating" with an insurance company. We can not guarantee that your insurance company will pay for your visit or that you will be charged “in-network” rates. When you seek our services and have insurance, you will be responsible for your co-payment at the time of service. We then bill your insurance for the services rendered, and if there are any charges not covered by your insurance, these become your responsibility. You will receive a statement for those charges. Any account which is not paid in full within 30 days of the invoice date must be paid in full before any further services can be rendered.
We encourage all of our patients to contact their insurance company prior to treatment to make sure that the visit will be covered at our facility. Although we participate with many insurance plans, some insurers may prefer that the patient be seen at another facility. It is your responsibility to know the limitations of your coverage and what your benefits include. You are financially responsible for all charges incurred for treatment.
No Out-of-State Medicaid (Michigan is not an exempt state)
No Out-of-State HMO if not listed
If you would like to pay by cash, check or charge and the patient does not have Medicaid or Medicare, you may still be seen at KFIC.
Please also note that we do not see Medicaid patients over 17. Most insurances allow us to see patients through 30. Please always ask us before you obtain service.
Within different insurance companies there are many different plans with different contract terms. Please note that health insurance is intended to cover some, but not all of the cost of your healthcare. It is important for you to become familiar with your insurance policy and understand what services your policy covers. This will allow you to receive the maximum benefits of your specific insurance plan. Please bring your insurance card and picture ID with you to each visit. Note that contracts are subject to change without notice. Insurance directories may not provide the most current provider listings. Please contact your insurance company with questions regarding your plan participation. This list is provided for informational proposes only and does not guarantee payment of medical claims. Check with your carrier to ensure we are in-network, you can usually find a telephone number for your insurance on the back of your insurance card.
If you don't see your insurance listed, please call. We may accept it under one of the PPO plan administrators. If we don't currently accept your insurance, we'd be happy to contact the carrier to see what is necessary to be credentialed. Whether or not your insurance plan is listed, KFIC will still make every effort to assure that you receive "in-network" benefits for your visit, but we cannot guarantee the visit will be charged at "in-network" rates. Your benefits are defined by a contract between you, as patient, and the insurance company. We are required to follow the terms of your contract and can not change your benefits or “modify” charges from the approved fee schedule. Most plans require co-payments, deductibles and/or co-insurance expenses, which must be paid by the patient. We can not “waive” co-payments, co-insurance or other charges due, this could constitute insurance fraud and may be illegal. We will attempt to collect payment of your co-pay, deductible or visit amount at the time of service.
Always check your Explanation of Benefits (EOB) to make sure you were billed correctly by your insurance company. If you have a plan for which we are not a provider or for which the insurance company does not provide coverage, you are responsible for the payment of any outstanding balance. KFIC is not responsible for incorrect information given by you or your insurance company or failure of your employer to provide accurate information to your insurer about your employment status.
Other Payment Arrangements
All charges for patients without insurance are due and payable at the time of service. If you do not have insurance or prefer to pay cash or with a credit card, please be advised we offer a 20% discount for same day of service payments for urgent care fees. To take advantage of this discount, you may not be a participant in the Medicare or Medicaid programs and your insurance must be out-of-network. The discount may not be applied toward co-payments, co-insurance or deductibles. Out-of-network includes patients covered under commercial and government plans (including Medicare and Medicaid) in which KFIC does not accept assignment and therefore does not submit claims to the carrier. However, patients may independently submit claims for reimbursement. Although patients with high deductible health plans and health savings accounts may be financially responsible for cost of their visits, the price is still determined by the terms of the provider’s contract with the patient’s insurance company so cash discounts generally do not apply. As a rule, cash discounts cannot be applied to co-payments. Health plans require co-payments as an incentive for patients to avoid using services unnecessarily and to shift utilization to in-network providers offering discounted care. Waving co-pays not only removes these incentives and violates most health insurance contracts, but for beneficiaries of government health plans, the practice may also be considered an illegal inducement to select one provider over another. Moreover, waiving co-pays could lead to liability under state insurance fraud or unfair and deceptive trade practice laws.
Cash (in person only at the office)
Return Visits for Same Problem
Sometimes medical problems are such that a patient has to be seen on more than one occasion for treatment. A patient may have a procedure performed, which requires a return visit, or the physician may want to re-evaluate an ongoing problem. According to most all insurance plans, patients are required to pay a copay for each patient visit and each provider evaluation.
If you have questions concerning your billing, please call our billing department at: (866) 376-9470.