Insurance & Billing

North Ottawa Medical Group is committed to providing you with exceptional service! The following two sections of information outlines your financial responsibilities related to payment for professional services. One section is for those who have medical insurance benefits, and the other section is for those who do not.

For our Patients with Medical Insurance Benefits:

We participate in most major health plans, including the following:

  • AARP (UHC affiliated)
  • AETNA
  • ASR HEALTH BENEFITS
  • BCBS (all products)
  • BCN (all products)
  • CARESOURCE of MI
  • CHAMP VA
  • CIGNA (Connecticut General CIGNA)
  • COFINITY (and all plans under this umbrella)
  • GOLDEN RULE (uhc AFFILIATED)
  • HUMANA
  • MEDICARE of MI
  • MERIDIAN (OLD Health Plan of MI)
  • MOLINA
  • MULTIPLAN
  • PHYSICIANS CARE HEALTH PLANS (ASR)
  • PRIORITY HEALTH
  • RAILROAD MEDICARE
  • TRICARE North Region and TRICARE for Life
  • UMR (UHC affiliate)
  • UNITED HEALTH CARE AND COMMUNITY PLAN

Our billing office will submit claims for any services rendered to a patient who participates or is a member of one of these plans and will assist you in any way that we reasonably can to help you get your claims paid. It is the patients responsibility to provide all necessary information before leaving the office. If you have a secondary insurance, we will automatically file a claim with them as soon as the primary carrier has paid. Your insurance company may need you to supply certain information directly. It is
your responsibility to comply with their request.

Please bring your insurance cards with you to every visit, in order for us to verify that we have correct information for you.

If you are covered by a plan that we do business with but don’t have an insurance card or if we are unable to verify your coverage, payment in full at each visit will be expected.

If you are insured by a plan that we do not participate with, payment in full is expected at time of service. As a courtesy to you, if the payment is made in full, we will bill your insurance plan for you and you will receive any benefits payable from them, directly to you.

Co-Payments:

Your insurance company requires us to collect co-payments at the time of service. Waiver of co-payments may constitute fraud under state and federal law. You will be expected to pay your co-payment at each visit. If you are unable to pay your co-payment, your appointment may need to be rescheduled. For your convenience we accept cash, check or the following credit cards: Visa, MasterCard, and Discover.

Waiver of Patient Responsibility:

It is the policy of the practice to treat all patients in an equitable fashion related to Account balances. The practice will not waive, fail to collect, or discount co-payments, Co-insurance, deductibles or other patient financial responsibility in accordance with State and federal law, as well as participating agreements with payers.

If you are unable to meet our payment expectations, please contact our billing office at 616.847.0000, to make payment arrangements, or to set up a payment plan. We are willing to work with you!

NON-Covered Services:

Medical services that are considered by your insurance company to be non-covered, out of network, or not medically necessary will be your responsibility. It is primarily your responsibility to know what is and what is not covered by your insurance company. We will do our best to work with you AND your insurance company.

For Our Patients with No Medical Insurance:

If you do not have medical insurance, payment for all professional services are expected at the time of service. Please do not hesitate to let us know if you have difficulty paying your account. We may be able to help by setting up a payment plan based on your individual situation. Please contact our billing office at 616.847.0000, to speak to one
of our account specialists.

Late Arrivals:

Because we value your time and the time of others, a patient that arrives late for their appointment will be “worked in” as soon as possible. If you are more than 15 minutes late and there are no openings left in the schedule for that day, your appointment may need to be rescheduled.

Appointment No-Shows:

Any patient who fails to arrive for a scheduled appointment without calling to cancel the appointment is considered a “no-show”. If you fail to call to cancel on more than one occasion, you may be charged a $25.00 no-show fee. If you fail to call to cancel your appointment 3 times within a 12 month period, you may be discharged from the practice.

Delinquent Balance Appointments:

Patients with a delinquent balance are required to make payment in full for future services. A delinquent account is defined as a patient balance in excess of 120 days if the patient has not made any payments or sought assistance with one of our account specialists. If payment is not made, services may be refused.

*We understand that financial hardship sometimes exists. Please let us know, by one of our account specialists. We May be able to help!