Thank you for choosing South Alamo Medical Group (SAMG) as your health care provider. We are committed to building a successful physician-patient relationship with you and your family. Your clear understanding of our Patient Financial Policy is important to our professional relationship. Please ask if you have any questions about our fees, our policies, or your responsibilities. It is your responsibility to notify our office of any patient information changes (i.e. address, name, insurance information, phone contact and email etc).
The patient is expected to present an insurance card at each visit. All co-payments and past due balances are due at time of check-in unless previous arrangements have been made with a billing coordinator. We accept cash, check or credit cards. Absolutely no post-dated checks will be accepted.
Insurance is a contract between you and your insurance company. In most cases, we are NOT a party of this contract. We will bill your primary insurance company as a courtesy to you. In order to properly bill your insurance company we require that you disclose all insurance information including primary and secondary insurance, as well as, any change of insurance information. Failure to provide complete insurance information may result in patient responsibility for the entire bill. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits. If we are out of network for your insurance company and your insurance pays you directly, you are responsible for payment and agree to forward the payment to us immediately. If your insurance plan is one with which we are not a participating provider, you will be responsible for payment in full. Including but not limited to those charges above the usual and customary allowance. However, as a courtesy, we will file your initial insurance claim and if not paid within 30 days you will be responsible.
Self-pay accounts are patients without insurance coverage, patients covered by insurance plans in which the office does not participate, or patients without an insurance card on file with us. It is always the patient’s responsibility to know if our office is participating with their plan. If there is a discrepancy with your information, the patient will be considered self-pay unless otherwise proven. Self-pay patients will be referred to the Family Assistance Program to apply for a discount rate prior to initial appointment. If application is declined by patient, self-pay patients will be required to bring cost of office visit at initial appointment and will be asked to make payment arrangements for the balance. Please ask to speak with a billing coordinator to discuss a mutually agreeable payment plan. It is never our intention to cause hardship to our patients, only to provide them with the best care possible and the least amount of stress.
Financial Assistance Program
South Alamo Medical Group offers a Sliding fee Discount program to all who are unable to pay for their services and receive care at the following locations: 7355 Barlite Suite’s 301, 201, 504 and 4203 E. Southcross Blvd. The discount program eligibility is based on applicant’s ability to pay and assures not to discriminate on the basis of age, gender, race, creed, disability, or national origin. Eligibility rate is determined by the Federal Poverty guidelines (http://aspe.hhs.gov/poverty). Please ask our admitting staff or contact the Financial Assistance Program Coordinator at 210-242-2000 to see if you qualify for the program.
South Alamo Medical Group ofrece un programa de descuento a todos los que no pueden pagar por sus servicios y recibir atención en los siguientes sitios: 7355 Barlite Suite’s 301, 201, 504 and 4203 E. Southcross Blvd. La elegibilidad del programa de descuentos se basa en la capacidad de pago del solicitante y asegura que no discriminará por motivos de edad, género, raza, credo, discapacidad o origen nacional. La elegibilidad está determinada por las pautas federales de pobreza. Por favor pregunte a nuestro personal de admisión o póngase en contacto con el coordinador de asistencia financiera a 210-242-2000 para ver si califica para el programa.
Claims Department Contact information
If you need assistance or have questions, please contact the Billing Department between 8:00 a.m. and 4:30 p.m., Monday through Friday at 210-242-2000
We accept assignment on Medicare claims. Medicare patients will be expected to pay their yearly deductible (if not met) and 20% co-payment. If at the time of service you provide Medicare card and have an HMO replacement with other Primary care provider, you will be fully responsible for the services provided to you.
**Medicare Yearly Deductible of $166.00 for 2016**
If your coverage is active, we will file your claim. Please bring proof of coverage to each visit. If at the time of service you provide Medicaid card and have an HMO replacement with other Primary care provider, you will be fully responsible for the services provided to you.
Laboratory drawing is provided by a laboratory company not associated with SAMG. The laboratory participating with your insurance carrier will bill you. If you have any laboratory billing questions, please contact laboratory directly.
Motor Vehicle Accidents/Workers’ Compensation
We do not do any Motor Vehicle Accident (MVA) and Third Party Billing and/or Workers’ Compensation. SAMG will refer you to medical providers that will provide you this type of care.
MISSED APPOINTMENTS/LATE CANCELLATIONS
Broken appointments represent a cost to us, to you and to other patients who could have been seen in the time set aside for you. Cancellations are requested 24 hours prior to the appointment. We reserve the right to charge $15.00 for missed or late canceled appointments. Excessive abuse of scheduled appointments may result in discharge from the practice.
The charge for a returned check is $35 payable by cash or money order. This will be applied to your account in addition to the insufficient funds amount. You may be placed on a cash only basis following any returned check.
Medical Record Copies
Patients, Attorneys and Insurance companies requesting copies of medical records will be charged:
$25 – 1 to 20 pages
$0.50 each additional page
A special handling fee of $10 will be charged if records must be delivered within 48 hours of the request.
The parent(s) or guardian(s) is responsible for full payment at the time of service. A signed release to treat is required for unaccompanied minors.
Outstanding Balance Policy
It is our office policy that all past due accounts be sent two statements. If payment is not made on the account, a single phone call will be made to try to make payment arrangements. If no resolution can be made, the account will be sent to the collection agency, or attorney, and possible discharge from the practice.
In the event an account is turned over for collections, the person financially responsible for the account will be responsible for all collections costs including attorney fees and court costs.
Regardless of any personal arrangements that a patient might have outside of our office, if you are over 18 years of age and receiving treatment, you are ultimately responsible for payment of the service. Our office will not bill any other personal party.