Insurance/Payment Options

Payment Options

At Palms, we believe the ability to pay should not be a factor in receiving quality medical care. We accept most insurance plans, as well as Medicare and Medicaid. We also accept VISA, MasterCard, American Express and Discover.

INSURANCE

Your insurance plan may not pay for certain procedures that it deems not "Medically Necessary," such as screenings, lab tests, or if you have exceeded your insurance limitation. Your insurance may also require the patient to see providers that have been contracted with your insurance plan. This includes auto, Medicare, Medicaid, private commercial and workman's compensation. If the insurance denies payment, you may be responsible for payment. Palms Medical Group bills all insurances as a courtesy. Again, it does not mean that we accept all plans.

Palms Medical Group asks that you present your insurance card prior to each visit. If there is a change in your coverage, please notify us immediately as this may affect how your claim is processed. Failure to submit correct insurance information at the time of your visit could result in you being responsible for payment of charges.

Your health insurance contract is between you and your insurance company. Any complaints regarding your coverage should be directed to your insurance carrier.

Workman's Compensation-It is your responsibility to report injuries to your employer and review with them your options for medical care and to obtain the insurance information for billing purposes.

Medicare-If you have insurance coverage besides Medicare, be sure to contact the Social Security office to verify that they have the correct insurance and order of coverage for you on file. This is known as Coordination of Benefits. You must also notify them if there is a change in coverage. Medicare may deny payment if you do not have the correct insurance listed at the Social Security office.

If you have a secondary insurance to Medicare, Medicare requires that Palms Medical Group has you complete a Medicare Secondary Payer Questionnaire. This form is known as the MSP Questionnaire. This questionnaire helps in determining if there is insurance coverage that may be primary to Medicare coverage.

If you have signed up with a Medicare Advantage program, we ask that you present that information prior to being seen. Due to multiple Medicare Advantage plans, you must verify that your provider participates with the plan you selected for your Medicare coverage. We will bill your Medicare Advantage plan as a courtesy; yet, if your claim is processed out of network or you did not provide the correct Medicare plan information, you will be responsible for payment for charges.

Palms Medical Group accepts the following Medicare Advantage Plans:

  • Humana Medicare
  • Blue Medicare
  • Medicare Complete Choice (AARP, Secure Horizons, Evercare)
  • Aetna Medicare
  • Coventry Health Medicare
  • United Healthcare Medicare
  • Wellcare

 

Medicaid-Medicaid helps pay for services that are medically necessary. Sports physicals are an example of services not payable by Medicaid. Medicaid encourages recipients to participate with manage care plans. If you have recently moved here or you have a plan that we do not participate with, please contact the local office of the Florida Department of Children and Families or contact the manage care plan to have your plan changed.

Dual Coverage Medicare & Medicaid-If you signed up with a Medicare Advantage Plan, Medicaid will not pay for your deductible or co-pay. The patient is responsible for these amounts that are due.

Sliding Fee Scale Program (SFS)-You may qualify. The SFS program is based on the federal poverty guidelines and covers all services provided at Palm Medical Group including discounted lab services, Dental, Behavioral Health and prescriptions at our pharmacy locations. To see if you qualify for discounted fees, download and complete the application and bring it to any of our locations for review.

Other Fees

  • Record Fees-There is a fee for copying health records. If you request a copy of your records, you will be charged $1.00 per page up to 25 pages. Thereafter, it will be $0.25 per page in excess of 25 pages payable before your records are released to you.
  • Sports Physicals-These are not covered by your insurance company or Medicaid. The patient is responsible for this charge; unless Palms Medical Group is providing free sports physicals. Check with any Palms Medical Group for times and locations of these services.
  • Refunds-Requests for refunds will be paid in a timely manner after review of the patients account. The account must be clear of any current charges and write offs. This will also include immediate family member accounts as well. If you believe have a credit on your account, please contact our Financial Services Specialists at (352) 463-4506.

Sports Physicals-These are not covered by your insurance company or Medicaid. The patient is responsible for this charge; unless Palms Medical Group is providing free sports physicals. Check with any Palms Medical Group for times and locations of these services.

Discounted Clinics-Each month, one of our offices provides a pap clinic to patients for a fee of $5.00. Certain times of the year we also offer Pain Clinic services that are provided through Palms Chiropractic and Palms Massage Therapy for a fee of $5.00. Call any of our sites to inquire about dates and times for these discounted clinics. Keep checking for our new clinic locations and new services.

Refunds

Requests for refunds will be paid in a timely manner after review of the patients account. The account must be clear of any current charges and write offs. This will also include immediate family member accounts as well. If you believe you have a credit on your account, please contact our Financial Services Specialists at (352) 463-4506.

Statements

Statements are mailed on a monthly basis to valid addresses. We ask that you please make sure that your correct mailing address is on file. If you have moved and did not notify us of your change of address, the balance that is on file may be forwarded to a collection agency for further collection activity.

Payment

Co-payments, co-insurance and any outstanding balances are to be paid in full at the time of service. It is important to notify the front desk staff if you are unable to pay in full prior to your visit. Services rendered that are not urgent must be paid in full. Patients will be responsible for full payment of all services if their insurance carrier does not pay within 90 days.

Palms Medical Group accepts payment by Visa, MasterCard, Discover, American Express, check, cash and money orders. Checks must have your name preprinted on them. A valid photo ID is required to pay by check and credit card. Any returned checks from the bank may result in a returned check fee of at least $25.00, depending on the value of the returned check.

Palms Medical Group attempts to contact patients with large balances either by phone or by mail to discuss payment options. If you do not respond to our attempts, the account may be forwarded to a collection agency. Also, a lapse in payment or inactivity may result in your account being forwarded to a collection agency. If you wish to discuss your account balance, please ask to speak with one of our Financial Services Specialists at (352) 463-4506. Due to confidentiality, we will ask for identification when reviewing the account. If a spouse is calling, we will ask to speak to the patient in order to receive permission to speak to the spouse.

NEED HELP?

Our Financial Services Specialists will work with you to review payment and insurance options. We also offer a sliding fee scale based on income level. Ask to speak with the Patient Advocate Coordinator at your local Palms' office or call 1-888-730-2374. You also can email a financial counselor at finance@palmsmg.org.

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