Thank you for choosing Western PodMed Clinic, Inc., A Podiatric Corporation, for your podiatry needs. We are all committed to enhancing the quality of your care and overall experience with us. One way of achieving this is by establishing clear communication regarding our policies and clear expectations of compliance with them.

The following information is provided to help you understand how your insurance works and your responsibilities. Please refer to our “Financial Policy” for further information regarding our financial policies.

Please contact the front office with any concerns you may have.

Healthcare Information & Patient Responsibility

It is the responsibility of patients to communicate healthcare information to our office immediately. Healthcare information includes the following:

❏ Insurance information/coverage
❏ Authorization & Referrals
❏ Responsible financial person/party
❏ Address
❏ Telephone number
❏ Fax/Email
❏ Emergency Contact
❏ Change of referring and, or primary care physician

What to Expect At Each Visit

Please note that regardless of your insurance status, each time you arrive for your scheduled office visit, you will be expected to check in and present your insurance card or any other relevant documents to the front desk before being seen by your provider.

Please contact the front desk if you have any questions or concerns. We are happy to assist you in any way we can.

Terms and Definitions

Deductible: A deductible is the initial amount of money an insured has to pay (out-of-pocket) before any benefits from the health insurance policy can be used. Most deductibles renew annually and begin in January, with services covered under the calendar year. However, others renew mid-year, in July. Some insurance carriers allow for a “last quarter carry-over,” whereby services during the last quarter of a year can be carried over and applied to the next year’s deductible. If you are unsure which you have, contact your insurance agent.

Co-Payment: A co-payment is a fixed amount you are required to pay for each medical service you receive, regardless of the cost of the service. Unlike a deductible that’s usually paid once a year, a co-pay is paid each time a healthcare service is used.

Co-Insurance: Unlike the fixed copay amount, coinsurance is a percentage of the provider’s service cost after the deductible has been met.

Co-insurance continues to be paid until you reach your “out-of-pocket” maximum. After that, the insurance company will pay for all covered services up to the policy’s maximum for the remainder of the year. Out-of-pocket maximums have a wide range of possibilities depending upon the insurance – from $500 to $1,000 or more.

Referral: Most Health Plans (HMOs) require a referral for your visits. For your first visit, please provide us with your referral obtained by your primary care physician. We must see you with an active referral. We will obtain future referrals for the services our providers order for you.

Out-of-Network: A Provider who has not contracted with your insurance company for reimbursement at a negotiated rate is referred to as an “out-of-network” provider.

Some health plans (for example, HMOs) do not reimburse out-of-network providers at all, which means that as the patient, you would be responsible for the full amount your doctor charges.

Other health plans offer coverage for out-of-network providers, but your patient responsibility would likely be higher than it would be if you were seeing an in-network provider.

Your Privacy

  • We respect & protect the privacy of all our patients.
  • Federal law – Health Insurance Portability and Accountability Act (HIPAA) – protects the handling, storing, and releasing of your healthcare information.
  • For more information regarding your privacy rights, please contact our staff members.

We look forward to providing you with the best service possible.