Private Pay Insurance (HMO)

• Although our providers are not "contracted" providers for certain insurance plans, under certain circumstances, a Health Maintenance Organization (HMO) plan may grant authorization for patients to be seen in our office. Patients with HMO coverage must contact their plan administrator, or primary care physician, to obtain the proper prior-authorization for services desired in our office. Authorizations must be submitted to our office in writing and must indicate reimbursement for services at our "usual and customary" rate. Appointments can only be made once the proper written authorization has been obtained. Please contact our office for details.
• Similar to patients with "contracted" insurance plans, the patient (or other guarantor) will be required to sign an authorization form, in which they will request that payment of authorized benefits be made payable to Ross Nathan, M.D., and/or George A. Macer, M.D., on their behalf, for any services provided to them. By signing, they also authorize any holder of medical and other information (relating to them) to be released to any entity (which may or may not include any insurance company, Medicare and its affiliate agents, state medical-assistance agencies, and/or any other governmental or private payer) for the purposes of paying any services provided to them.
• All unpaid claims, open-account balances, as well as any denial for payment by any insurance carrier is the patient's (or other guarantor's) responsibility. Therefore, the responsible party will be required to pay for all accrued charges until the account is satisfied in full. In addition, the patient (or other guarantor) will assume the responsibility to respond to any correspondence furnished by The Hand & Wrist Center, or billing service, regarding an outstanding account.

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