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Patient Information
Office Fees and Payments | Hospital Fees and Payments Insurance and Forms | Hospital Privileges | Prescription Refills
What to Bring to Your Appointment
You can open and then print the necessary patient forms using the links below.
New patients will also be given our Notice of Privacy Practices and will be asked to sign an acknowledgement of receipt at their first appointment. The link to the privacy notice is included here for your information only. The first consultation and all subsequent office visits must be paid at the time of service. In most cases, we will file a claim on your behalf for reimbursement. However, if you prefer to file your office visit yourself, please notify the receptionist so that it is not filed twice. The receipt you receive will contain adequate information necessary to file your own claim. We are happy to process billing and insurance forms for initial consultations, testing, and hospital stays. However, it is your responsibility to process any billing or insurance claims for follow-up visits. In the case of tests, you will not have to pay at the time of service if you have insurance coverage and provide us with an insurance form or other authorization for payment from a third party. We expect payment promptly if you receive a bill from our office for balances that may be due. We gladly accept Visa and MasterCard. Please feel free to discuss any questions you may have about billing with office staff. When a patient is discharged from the hospital, he will receive a bill for the doctor's services. If the patient has insurance coverage, they may send an insurance form or information at this time and a claim will be filed for these charges. If the patient has no insurance, the bill is due upon receipt of the statement and is past due after 30 days. If the problems arise, the patient should contact the office manager.
Northern Indiana Neurological Institute, P.C. physicians are providers for most major insurance plans. However, it is in your best interest to check your insurance providers list of participating physicians to be sure your plan allows you to be seen at our office. Also, please review the rules and limitations of coverage and reimbursement with your insurance provider. The office will submit claims for hospital stays or tests as long as the patient submits a claim form, properly filled out, with benefits assigned to the doctor. Please remember that insurance is considered a method of reimbursing the patient for fees paid to the doctor and is not a substitute for payment. Some insurance companies pay fixed allowances for certain procedures while others pay a percentage. It is your responsibility to pay any deductible amount, co-insurance or any other balance not paid by your insurance, unless your doctor has an assignment agreement with your company. We do accept Medicare assignment. After we receive payment from your insurance, you will be billed for any balance due. Payment is expected in full within 30 days, unless arrangements have been made in advance with our office manager. We know questions can arise on insurance matters and these should be discussed with our insurance department. We will be happy to help you receive maximum benefits; however, with the exception of Medicare, we are filing as a courtesy. In addition, we will file disability forms for a nominal fee.
The patient needs to take the prescription bottle to the pharmacy for refills. Upon request, the pharmacist will call the office for authorization to refill until the next office visit only. At that time, the patient should obtain a written prescription from the dctor. All prescription refills must be requested during normal business hours.
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