Insurance

Monarch Health Financial Policy And Procedures

Your clear understanding of our financial policy is important to our professional relationship. Please download a copy of our Financial Policy to read, sign and bring to the office on the day of your first appointment. Existing patients are required to sign a new copy of the financial policy on an annual basis. Please understand that payment of your bills is considered part of your overall treatment. In order to keep your cost of healthcare to a minimum, the following policies have been adopted for use at Monarch Health.

 

Fees And Payment

Fees are standardized and based on the complexity of your visit. Payment in full of your insurance co-payment or the complete balance of the bill, if you are a self paying patient, is required at the time of the service. Payments accepted are Visa, Master Card, American Express, Discover, cash, check or money order. We also offer no interest financing through Care Credit.

 

Required At Check-In

Each time you check in for your appointment you will be required to:

  • Verify personal contact information
  • Present current copy of insurance card
  • Pay any outstanding account balance
  • Pay your insurance copayment

 

Insurance Plans

Your insurance is a contract between you and the insurance company; we are not a party to that contract. We must emphasize that as a healthcare professional, our relationship is with you and not with your insurance company. Before your visit, please contact your insurance company to verify that we are participants in your plan and the services you intend to receive are covered. While filing of the insurance claims is a courtesy that we extend to our patients, all charges are ultimately your responsibility. In order for us to file a claim, you must present a current copy of your insurance card at each visit and communicate any changes in your personal contact information to us.

The following is a partial list of accepted insurance plans: Aetna, Anthem, Cigna, First Health, Fortis, Great West Health, Humana Choice Care, Mail Handlers, Medicare, Medical Mutual, Nationwide One Health, OSU Managed Health Care Plans, Private Health Care Systems, Trinity and some United Health Care plans.  

Please contact your insurance to verify our participation with your insurance company.

Due to some managed care rules, Dr. Deborah Cole-Sedivy may be listed as a primary care provider (PCP) under family medicine or family practice as they frequently do not list individual nurse practitioners as PCP’s. You may however see Dr. Cole-Sedivy or Heather Friedeman, CNP, as long as Dr Cole-Sedivy is listed as a PCP with your insurance plan. Most insurance policies specify that some of the cost of care is a patient responsibility. This can be accomplished through anycombination of copayments, coinsurance or deductibles. Copayments are due when you check in for your appointment. Coinsurance, deductibles, and other non-covered services are calculated by your insurance company and reported on your explanation of benefits. Once we are notified, we will add the appropriate charge to your account and send you a statement. This charge is due within 30 days of receiving the statement. Not all services are covered benefits in all policies, so it is very important that you understand the provisions of your individual policy. Some insurance companies arbitrarily select certain services they will not cover, so we cannot guarantee payment of all claims by your insurance company. Some common examples of non-covered services are certain laboratory testing and immunizations. In addition, some plans do not provide coverage for preventive care, work, sports or school physicals. Reduction or rejection of your claim by your insurance company does not relieve you of your financial obligation.

 

Self Pay

In order to address the needs of our patients without insurance and patients with insurance coverage limitations, we would like to offer a 20% discount off of our standard fees. This discount acknowledges the lower cost involved in billing and
collections when a claim does not need to be submitted with a third party payer. In order to qualify, payment needs to be made in full prior to or upon completion of the visit or procedure, and any outstanding balance remaining is not eligible for the discount. This discount applies to all medical services provided and is offered only at the time of service.

 

Medicare

We gladly accept patients with Medicare and will bill our services at the allowed rate. You will be required to sign an Advanced Beneficiary Notice (ABN) at each visit. This form will explain which services Medicare may not cover and that you may be
responsible for those charges. Any lab work performed will require a separate ABN to be filled out for the current laboratory provider.