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711 S. Hwy 27, Suite E

Clermont, FL 34711

INSURANCE RELATED POLICIES

Insurance Related Policy:

  1. Co-Pays:

  • Co-payment, deductible, or other owed amounts that are the patient’s responsibility under the rules of the Medicare or Medicaid program or any other governmental or commercial third-party payor may not be waived. Waiver of co-payments, deductibles, or other owed amounts may be a violation of federal law and is a violation of Vanguard Medical Center's policy.

  • Being a participating provider with most insurance companies, the insurance companies require that we collect these fees, as they are terms of your health care contract. Additionally, patients are ultimately responsible for all balances.

  • We DO NOT bill for co-pays.

  • Even if you carry a secondary commercial insurance that may cover your primary insurance co-pay, you are still required to pay your co-pay at the time of service.

  • We do not bill secondary insurance for the primary carrier co-pay.

  • For your convenience, we accept credit cards including Visa, MasterCard, American Express, Discover, and Debit Cards. WE DO NOT ACCEPT CHECKS.

  • Due to the constant changes in health insurance it is your responsibility to know your health coverage. If you should have any questions regarding if a certain procedure is covered, it is to your advantage to call your insurance company and find out exactly what your contract covers. Their customer service representatives will be happy to assist you.

   2. Secondary Insurers:

  • Having more than one insurer DOES NOT necessarily mean that your services will be covered 100%. Secondary insurers will pay based on the response of your primary carrier pays.

  • We DO NOT bill your secondary carrier.

  • You are responsible for any balances after your insurance has cleared primary.

   3.  Insurance Coverage Exclusions:

  • There may be certain services (examples: cosmetic procedures, some allergy services, functional medicine tests and services) that are not covered by your health plan. If so, payment is expected at the time of service.

    4. Plan Participation:

  • Although this practice accepts some insurance plans, it is virtually impossible for our office to verify whether or not our providers are covered on your particular plan. So we must ask that you confirm participating provider status directly with your insurance plan before coming in for your appointment. We will not be held responsible for non-coverage of a visit from a plan which we or a certain staff member is not part of the network. You will be expected to pay all balances.

    5. Insurance & Insurance Collection:

  • Please understand that insurance reimbursement can be a long and difficult process for our office. In fact, insurers will routinely stall, deny, and reduce payments. However, sometimes involvement from the subscriber (you) is essential in expediting processing and payment of a claim by your insurance plan. We would greatly appreciate your prompt attention to any materials or questionnaires your insurance company may send to you by responding to them immediately, as payment of the claim(s) may be pending your response to such inquiries.

  • Please refer to enclosed document for details of insurance benefits and copays.

    6. Auto Accident:

  • We DO NOT treat acute injuries related to auto accidents. 

  • If your injury is a result of an auto accident, you need to seek medical assistance in the emergency room or at an urgent care center.

  • For any follow up from ensuing injuries, you are required to pay for services and then collect from the auto carrier.

  • We will not file your insurance but will provide you with a receipt to do so.

  •  ​We DO NOT bill attorneys for services provided.

    7. Liability Injury:

  • We DO NOT treat acute injuries, 

  • If your injury is a result from another party’s negligence, you are required to pay for services and then collect from the responsible party.

  • We will not file your insurance but will provide you with a receipt to do so.

    8. Worker’s Compensation:

  • If your injury is due to an accident in your work place, please inform the receptionist

             immediately.

  • We are not authorized to treat you for this type of claim. You will need to contact your supervisor for instructions on how to file a worker’s compensation claim. We regret any inconvenience this may cause.

  • ​We DO NOT bill attorneys for services provided.