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Insurance
PRIVATE INSURANCE
You will be asked for insurance information and any updates or changes when you check in for your visit. This information is necessary in order for our billing department to file your claim. If your insurance requires a co-pay at the time of your visit you will need to pay that fee prior to seeing your provider or it may be necessary to reschedule your appointment.
Insurance companies frequently set fees that are below our customary charges or may deny payment for uncovered services. You may be asked to sign a waiver to assume the financial responsibility for any uncovered services.
If you do not have insurance, our billing department will be happy to work out a payment arrangement for you.
INSURANCE REFERRALS
If your primary care provider is a member of this clinic and your insurance requires a referral, please indicate that fact to your provider's assistant before any appointments can be made outside of this clinic. We will send the paperwork for referrals to your insurance. You will receive notice from your insurance company about the status of your referral. If you do not receive a notice after two weeks, call member services at your insurance company to inquire about the status of your referral.
After you receive approval from the insurance plan, you may schedule the appointment with the specialist to whom you are being referred.
If your referral is denied, please contact your insurance company to inquire why. It may be that the referral would be approved to another provider or with additional information. Some insurance carriers do not notify us when the referral is completed so we cannot help you with the information. You must call member services of your insurance company.
If your primary physician is not a member of this clinic you will need to confirm that we have received an approved referral before you schedule your appointment with a physician in this clinic.
PUBLIC ASSISTANCE/COUPONS
We will bill DSHS for your medical charges, when you present a current medical coupon to the front desk upon your arrival. We must have a current coupon for each visit or it will be necessary to reschedule your appointment.
If you have insurance in addition to medical coupons, please be sure to inform the receptionist as private insurance must be billed before public assistance. If a coupon is not given, you will be responsible for the charges incurred. If your primary physician is not a provider in this clinic then we cannot see you unless we have a referral from your primary care physician, a current medical coupon and your insurance information. If any one of these is missing you will need to reschedule your appointment.
FEES
As of June 1, 2010, Cornerstone Medicine operates as an outpatient provider for Memorial Hospital. State billing regulations are different for hospitals than primary care clinics. Patients will receive two bills, one from Memorial Physicians for professional services and another from Yakima Valley Memorial Hospital for facility fees. These statements are sent separately and often staggered based upon an insurance company's processing procedures. We bill insurance as a courtesy and wait for an assessment of patient responsibility before a patient receive billing from us. So, patients may receive the two statements for a single visit at different times.
Patients will initially have an increased out-of-pocket expense which will help meet insurance deductibles more quickly. Like all insurance, once the deductible has been reached, these fees are likely to be covered. For Medicare patients, we anticipate an average increase in co-insurance payments of $12 per visit. We encourage patients to consult their insurance providers if they have questions.