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Patient Financial Responsiblity

Medical Bills can be confusing regarding the amount a patient will need to pay out of pocket. The healthcare industry calls this amount of Patient Financial Responsibility. Patient Financial Responsibility charges include co-pays and any charges not covered by insurance.

Credit Card On File

At the time of service, we ask patients with insurance to pay their co-pay and provide a credit card on file.  This card will only be used if there is an additional payment owed after we have billed your insurance. The credit card information is stored securely, and patients will receive advance notification via email if and when the card will be charged.  The card on file will only be charged up to $150.  If a patient's responsibility exceeds the $150, other arrangements can be made for the remaining balance.

Example 1:

Co-pay & No additional Patient Responsibility

Co-pay: (at time of service)  $50

Charges:   $175

Insurance Payment:   $175

Additional Patient Responsibility:   $0

To be charge to card on file:  $0

Example 2:

Co-pay & additional Patient Responsibility less than $150

Co-pay: (at time of service)  $50

Charges:   $175

Insurance Payment:   $150

Additional Patient Responsibility:   $25

To be charge to card on file:  $25

Example 3:

Co-pay & additional Patient Responsibility greater than $150

Co-Pay (at time of service)   $50

Charges:   $350

Insurance Payment:   $150

Patient Responsibility:   $200

To be charged to card on file:  $150

Balance to be billed:  $50

Cash Deposit

If a patient does not have a credit card, Sovereign will accept a $150 cash deposit. Within 90 days of receiving notification from your insurance company of the payment status of the claim, either a refund will be issued to the patient or a bill will be sent for any outstanding balance.

Example 1:

Co-pay & No additional Patient Responsibility

Co-pay: (at time of service)  $50

Cash deposit: (at time of service)  $150

Charges:   $175

Insurance Payment:   $175

Additional Patient Responsibility:   $0

Amount to be refunded:  $150

Example 2:

Co-pay & additional Patient Responsibility Less Than $150

Co-pay: (at time of service)  $50

Cash deposit: (at time of service  $150

Charges:   $175

Insurance Payment:   $150

Additional Patient Responsibility:   $25

Amount to be refunded:  $125

Example 3:

Co-pay & additional Patient Responsibility >$150

Co-Pay (at time of service)   $50

Cash deposit: (at time of service)  $150

Charges:   $350

Insurance Payment:   $150

Patient Responsibility:   $200

Deposit applied:   $150

Balance to be billed:   $50

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