We at Optimal Ankle & Foot are committed to providing you with the best possible care. If you
have Medical Insurance, we are eager to help you receive your maximum allowable benefits. In
order to achieve these goals, we need your assistance and your understanding on our payment
policy.
- MEDICARE PATIENTS: We would like you to understand that accepting assignment means that
YOU are responsible for the YEARLY DEDUCTIBLE and for the 20% (co-insurance) of what
Medicare allows. You are also responsible for service that you’re supplemental/
secondary insurance does not cover.
- All co-payments are due at the time of visit. The returned check fee is $45.00.
- Co-insurance and unmet deductibles are due prior to scheduled surgeries and procedures.
Once benefits are verified and your financial responsibility calculated, you will be
notified of the payment amount and due date.
- If your plan requires a referral, it is your responsibility to obtain this prior to
being seen by our provider. It is also your responsibility to ensure that our physician
is in your insurance network.
- Cancellations for appointments and procedures must be received at least 24 hours prior
to the scheduled appointment. Cancellations for appointments will be charged $25.00
cancellation fee. Cancellations for scheduled surgery must be received at least 5 days
prior to the scheduled surgery date and time. Patient who fail to cancel a scheduled
surgery will be charged a $100.00 cancellation fee.
- Medical records requests must be received in writing at least 72 hours prior to the date
needed. Fees for medical records are set in accordance with allowable amounts as defined
by the state of New Jersey. Fees must be received prior to record delivery, the fee for
these records are $25.00.
- Administrative Services: There is a $25.00 charge for each Administrative Service
payable prior to service completion. This Administrative Service Fee covers specific
administrative services such as forms completion for family medical leave and disability
and letters for insurance authorization.
- PATIENT REFUNDS: Please allow 60 days from the time your insurance company responds to a
claim for your deposit refund to be processed. Refunds will be issued in the form of a
paper check that will be mailed to your home address.