Payment Policy
Payment and Billing Consent.
Thank you for choosing Sleep Health & Wellness for your healthcare needs. To ensure a clear understanding of our financial policies, we have outlined the following payment guidelines. Please take a moment to review this document.
1. Patient Responsibility
As a patient, it is your responsibility to understand your insurance coverage, benefits, and the portion of the bill that you are expected to pay. Please provide accurate and up-to-date insurance information at the time of your visit. You will be required to pay for services at the time they are rendered, unless arrangements have been made otherwise.
2. Insurance Information
It is essential to provide correct insurance information at every visit. We will verify your insurance coverage; it is ultimately your responsibility to ensure that the services you receive are covered by your plan. If your insurance changes, please inform us immediately.
- Insurance Verification: We will verify your coverage by requesting your driver’s license or state ID card and insurance card.
- Insurance coverage: Insurance benefits are not guaranteed. The final determination of coverage will be made by your insurance company.
- Pre-authorizations and referrals: If your plan requires a referral or pre-authorization, it is your responsibility to obtain that from your primary care provider or insurance company prior to receiving services. If a referral is needed, without one we will have to reschedule your appointment. If a referral is not obtainable at the time of your visit you may choose to be financially responsible for that visit.
- Secondary Insurance: It is your responsibility to provide the necessary information to ensure timely billing and processing.
- IMPORTANT: DIVORCED PARENTS: Patients under the age of 18 years of age must be accompanied by an actual parent or legal guardian. PATIENTS 18 YEARS OF AGE OR OLDER: Due to office policy and legislation (HIPAA law), patients must sign a release for the office to speak with a parent, spouse, or anyone other than the patient.
3. Payment at the Time of Service
We request that you pay your bill at the time of service. This includes co-payments, co-insurance, and deductibles.
- Deductible: the amount the patient pays before the insurance company begins to pay any amount as required by the specific plan they choose.
- Co-Pay: the amount the patient must pay per visit according to the insurance plan the patient has with the insurance carrier.
- Co-insurance: the amount the patient is required to pay according to a percentage (ex: visit is 80/20— insurance company pays 80% and the patient pays 20%)
At the end of your appointment, we will review the remaining balance with you. We request a same-day payment of 50% for the services rendered and the remaining balance before the next visit or at your sleep study appointment.
If you do not have insurance or do not cover certain services, you will be required to pay for those services in full at the time of the visit.
4. Payment Methods
We accept the following methods of payment:
- Credit Card (Visa, MasterCard, American Express, Discover). The patient is responsible for a 3 % surcharge when using this method.
- Debit Cards, Cash, Checks, and HSA/FSA Cards.
5. Patient Balances
If you have a remaining balance after your insurance has processed the claim, we will send you a first notice through the patient portal for the outstanding balance. Upon receipt of this notification, payment is expected; a second notice is a courtesy call from our office.
6. Financial Assistance
If you are experiencing financial difficulties, please inform our office staff. We may be able to offer a payment plan.
7. Outstanding Balances & Collection
If your account is unpaid within [90] days, we may refer your balance to a collection agency. You may be responsible for any collection fees or legal costs associated with the collection of your account.
8. Returned Checks
If a check is returned for insufficient funds, a service charge of $50 will be applied to your account.
9. Missed Appointments & Late Cancellations
A missed office visit appointment or late cancellation (less than 24 hours’ notice) may result in a fee of $50 and $75 for a sleep study appointment after a second occurrence. This fee is not covered by insurance and will be your responsibility.
10. Questions About Billing
If you have any questions regarding your bill or payment arrangements, please contact our billing department at 248-230-8492. Our team is happy to assist you.
11. Privacy and Confidentiality
All billing and payment information will be handled in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and the Michigan Medical Privacy Act (MMPA). Your privacy is important to us, and we take all necessary steps to ensure that your personal and financial information is kept confidential.
12. Fees for Medical Record Requests
In accordance with Michigan law, we are permitted to charge a fee for processing medical record requests. The patient/guarantor reserves the right to obtain medical records. The fees are as follows:
- Paper Records: $1 per page for the first 20 pages, and $0.25 per page thereafter. This will require to be paid before the request can be processed. The request will be processed within 10 business days from the payment date. Payments accepted are cash and credit card, the latter of which is subject to up to a 3% processing fee.
- Mailing services, (if applicable).
13. Acknowledgment and Agreement
By signing below, you acknowledge that you have read and understand our Payment Policy. You agree to abide by the terms outlined above and accept responsibility for payment of services rendered.