Please review these frequently asked questions about our financial policies. To expand an answer, click the + to the right of the question.
Who is in charge of billing and how do we contact them if I have a question?
Our billing is contracted out to SA Medical of Virginia. They are a reputable family owned private medical billing company of which many private physicians’ offices utilize in our area. Should you have a billing question contact them at (540) 374-4488, or on the web at www.samedical.net. Should you still have unanswered questions please contact our office directly and speak with our front office supervisor who will be happy to assist you.
How can I pay my balance?
We accept payment via mail to SA Medical or our office; and in person. CIMA accepts cash, check, or major credit card and follows the new protocol set by the FTC for physician offices. As a matter of practice policy we cannot accept your payment over the phone with a credit card. This is only to ensure your security from potential identity theft. Sending your payment by check in the U.S. mail may be the easiest method but you are welcome to come to the office and settle any balances in person during regular office hours.
Why is my co-payment due at the time of my office visit instead of just getting billed later?
Your co-pay for the services received on the date of service is actually contractually controlled by your insurance company. CIMA is obligated to collect this from you at the time of service as a partial payment for the visit. These regulations, as well as the amount collected, are stipulations from your private insurance company. It also serves a practical purpose as most insurance companies take 45 – 90 days to send payment to our office for services rendered; so your co-payment at the time services are preformed assists us in our base operations.
What if I have a deductable, how is that addressed?
Deductibles are different from co-payments. This is the amount out of pocket that your insurance company states you must spend before it covers any of our services. We generally do not collect this at the time of your visit as we must first bill your insurance company. After adjustments are made by your insurance a bill is sent to you for payment showing the amount the insurance has allowed us to charge you for the covered service and what amount is your responsibility. This is the final balance and what you send to CIMA.
Why do I get two statements, one from my insurance company and one from SA Medical?
In actuality you are only getting one billing statement. Insurance companies do not send billing statements for the practice. They will send you what is known as an E.O.B. (explanation of benefits) which lets you know as the insured that your company has received a bill from our office and what you may potentially owe to the practice. Do not pay CIMA based on the E.O.B from your insurance company. In some cases you may be paying too much. There are occasionally adjustments made and credits applied to your account that are reflected on your actual statement from SA Medical. Once you have received a statement from SA Medical that shows you the balance due than please remit payment for that amount to CIMA.
If I paid a bill at the CIMA office but also received a statement in the mail with a balance still showing what should I do?
If you paid a balance at the office sometimes it is not posted to your account until 3 – 4 days later and may miss the statement period being mailed. If your statement does not reflect your payment it is always best to call the office or SA Medical and check on the payment posting to be on the safe side.
I know I had been to the office and received services, but I have not received a statement, why?
There are a few reasons for this. There might be the situation where your insurance has been billed and we are waiting to hear back from them before a statement is mailed for your balance owed the practice. In the case of Medicare some claims can take several months to “clear” their office and it often delays SA Medical billing the patient so a statement may not come right away. Rarely the fault lies with the postal service or a faulty address. SA Medical mails all statements first class postage and if they are not deliverable they are returned to SA Medical. It is very important the CIMA office has the latest address on file for you to avoid this problem. SA Medical and CIMA investigate each returned statement and make an effort to contact you by phone to correct the delivery trouble and send out a duplicate statement; however if you have received services from our office and do not receive a bill in 30 – 45 days please contact our office or SA Medical to head off any trouble with your account.
I did not receive a statement but the billing office says I am still responsible for the delinquent balance and must make a payment immediately; why is this?
SA Medical sends out three statements before your account is in trouble and delinquent. Each statement is 30 days apart. So in order to not receive a bill there would have been a failure to deliver the statement 3 times in 90 days – a problem only encountered if we do not have a current address on file. We consider it the responsibility of the patient to alert our office of address, phone, and insurance changes so we can properly bill your insurance company and the patient to make this hassle free for us all. Failure to receive a statement does not remove your obligation for clearing your balance; and not receiving a statement should cause you to contact SA Medical or our office to clear up the problem.
What if my account is overdue and I am delinquent in clearing up my balance?
We understand the importance of your access to your doctors and not worrying about immediate payment; which is why we gladly give all patients a time period to pay outstanding balances. We are in this with you and want to give you the opportunity to quietly clear up existing balances with our front desk staff or SA Medical. If you have missed paying your balance and 3 billing cycles have passed you may get a concerned phone call from one of our staff to inquire if you are ok and if you are aware of the balance. Most of the balances are small and can be cleared up easily by coming to the office. It is only after this fails to resolve the issue that further collection action may be taken. This is rarely the case as our staff looks out for you and tries its best to notify you of any unsettled balance.
I am on Medicare as my primary insurance, why do I have to pay a part of my bill?
Medicare patients usually pay nothing (no co-pay) at the office for a visit except their monthly premiums. That is not the case in the beginning of each year when each Medicare patient has a deductable set by Medicare to pay out of pocket before the insurance company starts to pay the full cost. This deductable is set each year by Medicare so please read your CIMA statement closely as even if you have Medicare you may have a balance for which you are responsible.
I saw on my statement to contact my insurance as they did not cover any of my bills, can you explain why that might be?
When your insurance denies your claim in full they will give you a reason on your explanation of benefits (EOB). It may be, for example, that you have no insurance coverage for this particular problem; it was a preexisting condition; or your insurance has not responded at all to our office when we sent them the bill for services rendered to you. You can do two things to help clear up any insurance company confusion. First contact your insurance company and inquire as to why the particular service is not being covered or why they are not communicating with SA Medical over the bill. Second call our local outsourced billing company, SA Medical, and alert their staff you have called your insurance company and make a plan for resolving the issue. It is your responsibility to contact your insurance company and clear up any confusion they have so your bill can be properly billed. If this is not done then the full balance of the statement will be your responsibility.
What if my insurance won’t cover a service?
For sure it can be difficult to know if a particular service is covered by insurance. We try to let you know trouble areas we see with insurance if we have a prior experience with patient coverage issues but it is our policy that the patient is ultimately responsible for knowing what services are covered. If you are unsure than call your insurance company and ask prior to receiving the service from our office. If you have a service for which your insurance company will not cover than you are responsible for the fees for that service.
How long do I have to pay my balance?
Your balance, similar to other household bills you may have, is due within 30 days of the statement date. You can mail in your payment by check or come to the office and settle with cash, credit card, or check. If your balance goes unpaid than you will receive subsequent statements over another 60 days to clear this up. Staff may ask you to clear your prior balance when you come for another appointment and any balance over 60 days must be paid in full.
I did not show for an appointment and got charged a fee, can you explain why?
You were charged an office service fee for missing your appointment because you unfortunately had an appointment where you did not call to cancel in enough time for us to fill the slot (24 hours notice) or did not show for an appointment. We understand emergencies come up and you may need to cancel, and we take that into consideration; but we charge and enforce this service fee to discourage patients from causing this avoidable situation. We have a busy practice and patients can go unseen when they are having an illness or emergency themselves because time was taken up with your appointment that went unfilled where other patients could have had access when they really needed it. Our office makes every effort to avoid this situation for you as we know life can get away from all of us at times and you can innocently forget about an appointment. To avoid this we give you written appointment cards and call 48 hours in advance of your appointment to remind you and, if needed, give you time to reschedule a visit with enough notice we can get other patients in need seen. Most of our patients respect and appreciate this service fee as we do not double book our calendar out of respect for our patients and your time so visits that are gone to waste can really impact the access to our office. Our fees for this are similar to those charged by almost all other professional offices and work well to keep access to our office available.
Are there service charges for services not covered by my insurance company?
We often fill out quick forms or help you with a quick statement for your work or insurance free of charge. CIMA does charge nominal fees for certain services that require more time for the physician themselves to sit down with your medical record, review your file, and render an official opinion. Please check with our secretary if your request will incur a service fee. Fees for services are commonly charged for FMLA documentation, disability forms, letters about your medical care/diagnosis to a lawyer or judge, medical letters needed to document your medical status and render an expert opinion, forms filled out separate from an office visit, and life insurance documentation. Our fees for these services are due when services are provided and not billed through our billing company. We have enjoyed great patient understanding of these fees in acknowledgement of the time it takes for our physicians to review and generate your requested documentation.
What does the office recommend I do if I am on hard times?
We know good people can fall on hard times through no fault of their own and we want to help you. First, our physicians spend 99% of their efforts and time on your health care not worrying about what you owe. Staff can assist you with a payment plan to get caught up with your overdue balance and keep you in a good relationship with our office so we can continue to concentrate on caring for you. As long as you are making payment plan payments and clearing up your balance we are happy to avoid any break in services or collection action from our office. Our office, like your work, needs to pay employees and other bills to stay open and keep CIMA around to take care of you when you need us. We can only do this when patients are being responsible for their balance obligations. Discuss your special needs with our staff and they will be happy to work something out with you.