Private Pay Insurance (PPO, POS)

• Patients (or other guarantor) will be required to sign an authorization form, in which they will request that payment of authorized benefits be made to Ross Nathan, M.D. and/or Dr. George A. Macer, M.D., on their behalf, for any services provided to them. By signing, the patient (or guarantor) 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 the patient.
• It is the patient's (or other financially-responsible party's) responsibility to verify if Dr. Ross Nathan and/or Dr. George A. Macer, M.D. (and any associated entity rendering further medical services) is a contracted provider for the individual insurance plan(s) covering services for them. Unless prior arrangements are made beforehand, all co-payments and pre-determined costs are due at the time of the office visit(s). Any deductible amounts (if applicable) that have not been met, by the time of treatment in the office, will be appropriately collected at the time of service. The amount of collection for outstanding deductibles will be a minimum of 50 percent, if the full amount is not paid.
• 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 PPO/POS Patients