Billing/Insurance/Referrals

Billing And Insurance
We participate with many insurance plans. Each plan has different benefits and financial obligations and not all insurance policies cover all of the services we offer. It is your responsibility to check with your insurance company to determine covered benefits and any requirements, such as deductibles or co-pays.

Payment/co-payments are due at the time of your office visit. We prefer not to send bills because the costs of statements and postage can affect our fees. You may pay by cash, check or credit card (VISA, MASTERCARD, AMEX, DISCOVER). If you have insurance, we will a file your claim for you. In order to file your insurance claim we need a current copy of your insurance card. If we are a participating provider you will be responsible for your co-pay, deductible or percentage, if applicable. If we are not a participating provider for your insurance, payment is expected in full at the time of service.

~It is your responsibility to ascertain that your medical provider is a participating provider with your insurance company.
~You are responsible for verifying your insurance benefits and coverage prior to any visits so that you are not billed for unanticipated charges. Some insurance companies do not cover some routine and non-routine services. Non-covered services will be billed directly to the patient.

Insurance Payment for Lab Tests
Because of the rising cost of medical care, some insurers are changing their policies regarding payment for laboratory tests. Simply speaking, lab tests are of two types: diagnostic tests and screening tests.

Diagnostic tests - Your doctor orders diagnostic tests when he or she becomes aware of signs or symptoms of a specific problem or when monitoring the course and treatment of disease or injury. Even if a test is ordered to monitor a disease, some insurers place a limit on how often the company will pay for it for you. If your doctor believes that a test must be performed more often than your insurer allows and you choose to follow your doctor’s advice, you will be responsible for paying for the test.

Screening tests - Your doctor may order screening tests as part of a checkup or annual exam. In general, screening tests are performed to try to prevent health problems, rather than treat them. Appropriate screening tests are based on factors sucn as your age, personal and family history, and generally accepted medical practice. Some insurers place a limit on the number of times the company will pay for a specific test for you. If you choose to have the test regardless of the insurer’s limit, you will have to pay for it.

Deciding to have a test for which your insurer will not pay - Tests ordered for screening purposes can be an invaluable tool in managing your health. They can confirm your general well-being or indicate that a health problem exists – even before symptoms appear. If your insurance will not pay for a test, does that mean you don’t need it? No. Whether a test is appropriate is based on a discussion between you and your physician, regardless of whether an insurance company will pay.

Birmingham Internal Medicine Associates, P.C. is not financially affiliated with the laboratory that performs your diagnostic testing.

Referral Request
We require 7-10 business days to process your request after your physician has approved the request for all referrals.. Referrals will be sent to the specialist's office in time for your appointment. Please call or fax our office with the Name of the physician, appointment date, phone # of the physician, reason for visit and a number we can reach you at should we have any questions.

If your insurance company OR insurancy policy numbers have changed since your last visit, please FAX us a copy of your new Insurance card (front and back) Fax 930-2063