Billing and Patient Financial Responsibility
at (812) 482-7441 and ask to speak to the Billing Office.
If no insurance is to be filed by us, or if we are not a participating provider in your insurance plan, full payment is expected at the time of service. If necessary, we can set up a payment schedule. Payment arrangements will be made with the approval of the Billing Office.
Co-Pays are due at the time of service. If you do not have insurance, you must make payment arrangements prior to your initial visit. If you need to make a payment, please call (812) 482-7441. We will be happy to take your payment over the phone!
Children under the age of 18 will require the signature of a responsible party on the registration form.
Worker’s compensation will be filed if the patient notifies us when scheduling the appointment and supplies billing information at check-in. Details of the accident will be required and a workers’ compensation form must be completed.
Accepted Payment Methods
- Money Orders
Past Due Accounts
Any outstanding balance after insurance has paid will be invoiced to you on a statement. Payment is due upon receipt of the statement. Prolonged delinquency in payment may result in the preparation of account for small claims court, collection agency and/or credit bureau reporting with possible discharge from the practice.
The submission of false information on a patient account will result in the account automatically being turned over to collections (i.e. fraudulent mailing address and other necessary contact information). In the event an account is turned over for collection, the person financially responsible for the account will be responsible for all collection costs including reasonable attorney fees and court costs.
A patient may remit in full for all outstanding charges owed on the account including amounts previously placed with the collection service. Under these circumstances, a physician may reserve the right to re-establish the patient to active status in the practice.
Physicians do not discuss financial issues. Our staff is trained to discuss your account with you. If you find it necessary to make payment arrangements, please ask to speak to the Billing Office.