Office Policies

policiesFees

  • All co-pays, co-insurance, and deductibles are expected at the time of service.
  • We accept cash, check, Visa, Discover, MasterCard and American Express. We use Square for our credit card merchant. Click here.
  • Return Check or Charge Back Fee is $35.00

Medical Forms

Requests to complete FMLA and disability forms, attending physician statements and any other additional insurance forms require not only office supplies, but time for the staff and doctors to complete. Because of this we charge a $25 fee to complete these forms. This fee must be paid in advance. Please be advised, it normally takes us 14 days to complete the form, so we ask that you make arrangements according to this time frame. The fee to complete non-standard or multiple page forms may be higher.

Referrals

We require a referral for all new patient visits regardless of the insurance plan.

Insurance

There are many types of insurance plans, so it is impossible for our financial coordinator to know all the details about each patient's insurance policy. We ask that you familiarize yourself with your plan and benefits. Please bring your current insurance card to each appointment so that we can obtain accurate billing information. Please be advised, our office cannot file your insurance claims or accept assignment of benefits without proof of insurance. If you fail to provide sufficient proof of insurance at the time of your appointment, payment in full is required, until we receive sufficient insurance information.

If you do not receive an explanation of benefits (EOB) from your insurance provider 45 days after your appointment or procedure, please call your provider to find out if additional information is needed so your claim can be processed. Unfortunately, any or all amounts paid for service may not be applied to your in-network benefits. This is beyond our control. Patients are responsible for any balance not paid by the insurance company.

Appointments

Our doctors see patients by appointment only. This makes it more convenient for each patient and ensures that we can provide the best care. Although we make every effort to stay on schedule, emergencies can occur, and can cause schedule delays. We ask for your understanding and patience when these situations arise.

At every appointment, please check-in at the front desk and notify the staff of any changes to your personal and insurance information since your last visit. Please note, when you provide our office staff a telephone number, including a cell number, you are giving us consent to contact you at that number for issues pertaining to treatment and billing.

Emergencies

One of our doctors or a covering physician are always on-call to assist with emergencies. If you have an emergency during office hours, please call us. Give the office staff your contact information, doctor's name and the reason for your call. On weekends and after office hours, the answering service will give you contact information for the physician on-call. The front office staff schedules appointments and handles all medication re-fill requests and non-emergent calls during normal business hours (Monday - Friday: 8:00 a.m. - 4:30 p.m.)

Insurance Companies

Springfield Nephrology Associates (SNA) participates in most managed care plans. Our commercial insurance contracts are through the Mercy Network. SNA accepts Medicare and Medicaid assignment.

We will file your claim with your insurance for the services we provide you. You are responsible for any balance identified by your insurance carrier, including but not limited to co-payments, co-insurance, deductible, non-covered services, and out-of-network charges.

If you are unclear about whether our providers are covered under your plan, contact your insurance company to verify. Tell them that we are in the Mercy Network (formerly St. John's Network). Your insurance company will be able to tell you what your benefit plan provisions are for our office.

Please be advised that some insurance plans issue our payments directly to the insured (aka policyholder). When this occurs SNA expects to receive the insurance reimbursement from the patient in accordance to the explanation of benefits (EOB) we receive. If this does not occur we will expedite our collection practices to seek our reimbursement.

Medical Records

If you to want obtain your medical records please download the Medical Record Release form. After you complete, print and sign the form please fax the form to 417-886-1100 and/or mail the document to 1911 S. National, Suite 301, Springfield, MO 65804.

We will share your medical records with other healthcare providers at no charge. Medical records going to an attorney's office will require a charge. Charges will also be applied to insurance companies seeking information that is not a part of claims management or reimbursement.

Our patients can access a limited amount of their medical record through our patient portal: https://go.acumenehr.com/health/portal/login.aspx.

Third Party Entities

We will not release any patient medical record without a signed patient consent. Third party entities must prove that they are a part of a CMS, RAC audit or associated with the OIG to be granted exclusion. Risk management audits must only be for specific dates of service and must not require the entire medical record. If a complete chart is required then the requesting entity must obtain a patient authorization. All risk adjustment audits must come from the subscriber's insurance company, on their letterhead, to request patient medical records. We will not accept bulk requests from contracted vendors.

HIPAA