Our Policies:

FINANCIAL POLICIES


We need to update personal information files on each patient every year.

We need to update your personal information yearly in order to make sure your insurance is billed properly. Please inform us of any change in insurance, address, employer, or retirement.


What payment is required?

Copayment is required at the time of your visit. A $5 service charge will be added to your bill if it is not paid at the time of your visit. For certain insurances, and self-pay patients we require full payment at the time of the visit. We reserve the right to charge a $5 service charge if this is not


Allowed forms of payment:

We accept cash, check, Mastercard, Visa, and Discover card. Please ask for a receipt with all cash payments.


The patient is responsible for total charge.

Any balance billed should be paid within 30 days. After 120 days any unpaid balance will be sent to collections. We will terminate any doctor/patient relationship (with sufficient notice) that has been sent to collections.


Outside testing/referrals:

You are 100% responsible for the cost of any lab work, radiologic tests or other procedures done here or elsewhere. It is your responsibility to know what testing your insurance covers. For certain tests our office will attempt to get authorization from your insurance company, but it is YOUR responsibility to let us know if you need authorization. Please let us know 1 week in advance of your test. Confirm with our office 48hrs prior to your test that authorization is complete.


Charge for insufficient funds check:

There is a $25 dollar fee for bounced checks.


Charge for copies of charts

There is a $0.25 charge per page of your chart.


Emergency Services and Surprise Bill Disclosures

New York State passed legislation on April 1, 2015 called the Emergency Medical Services and Surprise Bills Law. Please note the following:

North Country Adult Medicine is a participating provider in many health plan networks. A list of participating insurances is listed below for your review. Please note, some health plans use smaller networks for certain products they offer. Accordingly, it is important that you check with your health plan to confirm the provider is included in the network under your specific insurance plan.

Also, providers at North Country Adult Medicine are affiliated with St. Lawrence Health Systems. You should contact the hospital system directly to find out which health plans the hospital participates with, at (315) 764-1711.

If you find that North Country Adult Medicine does not participate with your health plan, and you would like information regarding the charges and estimated amount you will be billed for services, please contact North Country Adult Medicine at (315) 764-1121 from Monday -Friday, 8:30 am – 4:30 pm, and we will be happy to provide you with this information.

It is strongly recommended that you confirm coverage with your individual insurance plan prior to receiving any services in the office or any services that your provider may refer you for such as: laboratory services, radiological, physical therapy, echocardiograms, or any other service that your provider deems necessary.

We currently accept the following insurances:

Aetna: Commercial and Medicare
CDPHP – Capital District Physicians Health Plan
Cigna
Coventry Healthcare
Excellus Blue Cross Blue Shield -Includes Essential Plan
Emblem Plan
Fidelis: Commercial and Medicare
Humana
Martin’s Point
Medicaid
Medicare
MVP: Mohawk Valley Physician
NALC: National Letter Carrier
Tricare East
United Healthcare: Empire, Community Plan, and Medicare
Wellcare


We welcome the opportunity to discuss any aspect of our financial policy.


RETURN TO OUR POLICIES

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38 Hospital Dr, Massena, NY 13662, United States
(315) 764-1121

North Country Adult Medicine / © 2020 / All rights reserved.