Private Pay Insurance (Out of Network)

• Although our providers may not be "contracted" with certain insurance plans, when "out of network" benefits are available, we may proceed to submit claims for medical services provided. It is the patient's (or other guarantor's) responsibility to verify if their plan offers "out of network" benefits. Please be advised that "out of network" benefits (when available) may be paid at a lower reimbursement rate compared to "in network" benefits. This information may be verified by calling the insurance company.
• 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 the patient) 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.
• Unless prior arrangements are made beforehand, a minimum of 50 percent of the total anticipated daily charges will be appropriately collected, at the time of service, for "out of network" plans.
• 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.

« Back to Financial Policy | Download Forms for Out-of-Network Patients