What is my financial responsibility for services?

It is your responsibility to verify that the physicians and the practice where you are seeking treatment are listed as
authorized providers under your insurance plan. Your employer or insurance company should be able to provide a
current provider listing.

The patient or the patient’s legal representative is ultimately responsible for all charges for services rendered.
“Non-covered” means that a service will not be paid for under your insurance plan. If non-covered services are
provided, you will be expected to pay for these services at the time they are provided or when you receive a
statement or explanation of benefits (EOB) from your insurance provider denying payment.
ultimately, it is your responsibility to call your insurance company to determine what your schedule of benefits
allows, if a deductible applies, and your potential financial responsibility.

Your insurance company offers appeal procedures. We will not under any circumstances falsify or change a
diagnosis or symptom to convince an insurer to pay for care that is not covered, nor do we delete or change the
content in the record that may prevent services from being considered covered. We cannot offer services without
expectation of payment, and if you receive non-covered services, you are responsible for payment for these
services if your insurance company does not. If you are unsure whether a service is covered by your plan,
ultimately, it is your responsibility to call your insurance company to determine what your schedule of benefits
allows, if a deductible applies, and your potential financial responsibility.

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