Insurance and Payment Policies
Thank you for choosing Carteret Foot and Ankle Specialists, PC to provide you and your family with quality podiatric care. We are pleased to participate in your foot care and look forward to establishing a lasting relationship with you. We feel the better you understand our policies, the better we can serve you.
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INSURANCE
We participate with Medicare, Federal BCBS, BCBS of NC, Humana, Tricare (Humana Military), and Optum Community Care for Veterans as well as several other commercial carriers, including Aetna, Cigna, MedCost and others. Since insurance policies vary greatly in what they cover, it is your responsibility to:
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Verify that the provider you are scheduled with actively participates with your insurance plan
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Know your benefits, deductible, co-insurance and co-pay requirements prior to your visit
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Verify that the provider you are scheduled with actively participates with your Ensure that all pre-approved requirements are met to avoid denials or out-of-network benefits
Your insurance policy is a contract between you and your insurance company. In the event that one of our providers does not have a participation agreement with your insurance plan, please be aware that some and perhaps all of the services provided may be non-covered and you will be responsible for the full amount not paid by the plan.
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According to NC Statue 58-22253, insurers are required to pay a properly submitted claim within 30 days. It is your responsibility to provide the correct information to our office so a claim can be properly submitted. Most often, errors in billing are related to incorrect information. It is your responsibility to promptly furnish requested information to your insurance company. Many times claims are delayed because the subscriber has failed to respond to a request for information from their carrier. If either the practice or the plan fails to receive accurate information to process your claim, you will be held responsible for the charges. Payment not received in 60 days from your insurance company may transfer to patient responsibility and you will be responsible for payment. If we receive payment at a later date, you will be refunded by Carteret Foot and Ankle Specialists.
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COPAY, COINSURANCE, DEDUCTIBLE
Many plans require that a patient pay a co-pay at each visit. We will collect your co-pay when you check in. If you do not have money to pay your copay we will ask you to reschedule to a later date when payment is available. To avoid collection issues and unnecessary billing expenses, we will collect at the time of service any percentage co-insurance or deductible not met. The amount calculated is based on our negotiated fee schedule with the carrier or our standard rates if we are out of network.
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DELINQUENT ACCOUNTS:
An account is considered delinquent if the statement is not paid by the next billing cycle. Failure to pay will result in your account being turned over to an outside collections agency.
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PAYMENT METHODS:
We accept cash, checks, Visa, and Master Card.
UnitedHealthcare and Medicaid
Beginning January 1, 2025, an important change concerning our contract status with two insurers will take place.
First, in regards with our relationship with United Healthcare (UHC). Effective January 1, 2025, our office will no longer be contracted with UHC. This decision was made due to
United Healthcare's refusal to reach a compromise in contract negotiations that would reflect the fair value of the healthcare services we provide.
Secondly, we are no longer providers with Medicaid. Beginning January 1, 2025, we will not send primary or secondary claims to Medicaid.
If either of these insurers is your primary insurance, we will see you on a self-pay basis. If UHC or Medicaid is your secondary insurance, you must pay any co-pay for your primary insurance at the time of your visit. After your claim has been processed by your primary insurance, it will not be filed with your secondary and will immediately become patient responsibility.
We understand that this change may raise questions, and we want to assure you that we remain committed to providing you with the highest quality care. Although we will no longer be in-network with UHC or Medicaid, you are still welcome to receive services in our office on a self-pay basis. Our staff can assist you in understanding the options available for self-payment.
If you choose to seek care with another provider, we will gladly transfer your medical records upon request to ensure a smooth transition.