William Cromwell, MD, FAHA, FNLA
Lipoprotein and Metabolic Disorders Institute, PLLC
Our Financial Policy
For your convenience, our financial policies are listed below.
1. All charges must be paid at the time of service. Our treatment fees are the same for all patients, regardless of insurance coverage or not, as is required by law.
2. The contract with your insurance company to pay for a portion of your medical care is between you and your insurance company. By eliminating costs associated with billing, coding diagnoses and procedures, referrals, authorizations, payment delays, EOB reviews, claim denials, re-submissions, collection risks, and other managed care costs, we can provide patients a fair price for services without costs associated with administrative hassles and bureaucracy.
3. For your benefit, we will always provide you with a list of our fees and billing codes before any services are performed. We recommend you contact your insurance carrier to verify your benefits so you will have a basic understanding of how your insurance will reimburse you for the services provided by our office. Unfortunately, insurance carriers are not always willing to provide their allowable fees or disclose which billing codes they will cover. If this is the case, you may want to contact the NC Department of Insurance.
4. It is your responsibility to obtain all referrals/authorizations required by your insurance plan and to file your claim with your referral/authorization.
5. You will be given a completed receipt (and a duplicate copy for your records) with all the codes necessary for you to file a claim with your insurance carrier. We recommend you contact your insurance carrier and request instructions for filing your claims.
6. Our office does not fill out “forms” from insurance companies. A copy of the patient’s medical records will be forwarded to the insurance company when a signed authorization to release medical records is received. Their medical review professionals can extract the information required from these records.
7. Please Note: We do not charge interest, therefore, we are unable to offer in-house financing or payment plans. If you are unable to pay for your services in full with cash, check or money order, you may put the balance on your credit card and make monthly payments to your credit card company.
8. Our clinic is state-of-the-art and our entire staff is exceptional. Our service is superb. Nothing about our practice is “usual” or “customary” – terms employed to justify the comparison of our fees, designed to provide for complex medical diagnosis and treatment, to those allowed by outdated insurance fee schedules.
9. Medicare: Dr. Cromwell has chosen to “Opt Out” of Medicare. All patients who are on Medicare, or are eligible for Medicare, must sign the federally mandated “Private Contract” in order to receive services at our clinic. All services must be paid at the time of service and neither Dr. Cromwell nor the patient may file a claim to Medicare for reimbursement.
10. Medicaid: We are not accepting any Medicaid patients. We will only accept “Private Pay” patients. We will not file any claims to Medicaid for reimbursement of your medical services now or in the future.
11. Champus / Tricare: We are not an active Champus/Tricare/Tricare for Life provider. We will not accept Champus / Tricare / Tricare for Life insurance, we will not file any claims to Champus / Tricare / Tricare for Life and we will not accept the Champus / Tricare / Tricare for Life fee schedule for reimbursement of our services.