Thank you for choosing Peninsula Hearing Services as your hearing healthcare provider. We are committed to your successful treatment. Please understand payment of your bill is considered part of your treatment.

Health insurance and medical billing has become a complex issue that is no longer within the scope of most healthcare provider’s expertise. For that reason we have contracted with Valley Medical Services to perform this task.

They will work to ensure any claim they process for you is filed accurately and promptly. Should you have a billing question, please contact them at (800) 807-9843.

Insurance Coverage

If you do not have health insurance, payment is expected at the time of service unless you have made prior payment arrangements with our office.

Insurance Coverage Exclusions

There may be certain services that are not covered by your health plan (example: hearing device repairs, shipping charges, L &D deductibles). If so, payment is expected at the time of service.

Plan Participation

Although this practice accepts many health insurance plans, it is virtually impossible for Peninsula Hearing Services to verify whether all services are covered by your particular plan. Therefore, we advise that you confirm participating provider status directly with your insurance plan before your appointment. We will not be held responsible for non-coverage of a visit from a plan which we are not part of the network. You will be expected to pay all balances.

Secondary Insurers

Having more than one insurer does not necessarily mean that your service will be covered 100%. Secondary or supplemental insurers will pay based on the response of your primary carrier. We may bill your secondary health insurance carrier as a professional courtesy. You are responsible for any balances after your primary health insurance has cleared.

Co-Pays

All health insurance co-pays are due at the time of service as required by your insurance company.

Referrals

If you belong to an insurance plan that requires a referral for services, it is your responsibility to obtain that referral prior to your visit with us.

Insurance Collection

Insurance reimbursement can be a long and difficult process for our office. In fact, insurers are routinely inefficient, dysfunctional, short-staffed, difficult to reach and are believed by some to stall, deny and reduce payments. However, our billing service is highly skilled and extensively trained to maximize your insurance reimbursement while reducing the time in which they pay. Likewise, if you feel your health insurance has failed to appropriately process your claim, you may contact the California Department of Insurance and file a complaint for an investigation (website: www.insurance.ca.gov ; phone: 800-927- 4357). However, sometimes involvement from the patient (you) is essential in expediting processing and payment of a claim by your insurance plan. Your prompt attention to any materials your insurance company may send to you may expedite your claim by responding to them immediately, as payment of the claim(s) may be pending your response to such inquiries.

Patient Account Statement

An account balance becomes the patient’s responsibility for three reasons:
1. Your insurance has paid for services and the balance remaining is the member’s responsibility.
2. Your insurance has been billed but the plan has either denied or not responded to the claim submission within 60-days of the billing date.
3. No insurance information or invalid information for you exists in our files.

You will receive a monthly statement with your account balance. If you have insurance your statement will show what has been determined to be your responsibility from the claim response of the insurance company.

An unpaid balance is considered past due after 60-days. If two consecutive statements have been sent to you but no payment has been received on your account to reduce your responsibility, you may receive a collection letter and be considered for further collection activity. If your account must be turned over to a third party collection agency, you risk damage to your credit. This action would also cause a breach in the healthcare provider/patient relationship, resulting in denial of services until the account is paid in full or discharge from the practice.

Missed Appointments/Late Cancellations

If you are unable to keep your appointments, we request that you give Peninsula Hearing Services no less than 24-hours advance notice of your cancellation. There may be a fee for late cancellations or “no-shows”. If you “no-show” without calling multiple times or reschedule with less than 24 hours advance notice multiple times, you may be discharged from the practice.

Minor Patients

Unaccompanied minors will be denied services.

Copy of Medical Records

You may request a copy of your hearing evaluation at the end of your visit at no-charge.  Should you or another healthcare provider request a copy at a later date, our office reserves the right to assess a $25 administrative charge + $0.25 per page to process and then mail/fax another copy for your benefit.