Financial Policy

The surgeons, physicians, PAs, and staff at Lake Placid Sports Medicine are dedicated to the best possible care for you, and we want you to completely understand our financial policies in order to hold down the cost of medical care by eliminating the need for us to bill you. If you have any questions regarding our financial policies, please contact our office at (518) 523-1327.

Check In, Referrals and Forms

At Check In – You must present your insurance card(s) at each visit. Your co-pay is due at the time of service. We accept cash, checks, money orders, MasterCard, and Visa. Please notify us of any address, phone or insurance changes. Any returned checks will be charged a $10.00 fee for processing.

It is your responsibility to ensure that we participate with your insurance carrier and whether you need a referral from your PCP prior to an appointment. Our office cannot always tell you in advance whether your charges will be covered by your insurance plan. Each insurance carrier has multiple plans that can vary with employer group contracts. It will be your responsibility to pay for any changes not covered by your plan.

Minor Patients (under 18 years of age) – The parent(s), guardian(s), and/or adult(s) accompanying a minor is responsible for providing current insurance information for the minor and/or payment in full of any co-pay due at time of service. Please be aware that we do not get involved in any child custody and/or divorce decrees. The adult accompanying the child is responsible for any co-pay or balance due at the time of service. All patients under the age of 18 must be accompanied by a parent(s) or legal guardian(s) for each appointment.

Referrals – If your primary care physician refers you to Lake Placid Sports Medicine and your insurance plan requires a referral, it is your responsibility to make sure your PCP has called that referral in to your insurance carrier. We will have to reschedule your appointment if you do not come to your appointment with the proper authorization number. We are only responsible for getting referrals for services that we require done at Lake Placid Sports Medicine (i.e. MRI’s).

Disability Forms- The fee for completing disability forms is $5.00 each payable at the time the form(s) are dropped off at the office. Please make sure your employer section and your section are completed in full as we send the original into the disability company and mail the patient a copy for records. We do not fax disability forms. 


Worker's Compensation and NYS No-Fault

Worker’s Compensation – Your employer must file an injury report before an injury can be billed to Worker’s Compensation. It is your responsibility to contact your employer. You will need to provide us with the compensation insurance carrier, their address, date of accident, WCB numbers and all claim numbers related to your comp case, as well as case manager name. If we lack any of this information, you will be billed the full balance of charges rendered until we receive the information we need.

NYS No-Fault – We will need your no fault insurance carrier, their address, date of accident, all claims numbers related to your claim, and the claim adjuster’s name and phone number.

*For all worker's compensation and no-fault cases you must provide us with your regular health insurance information and a referral, if necessary. In the event your claim is denied as a work related or motor vehicle accident, we will then bill your regular health insurance plan. If you do not have other health insurance, you will be responsible for the charges.


Insurance

School Injury Insurance – If you are a student and were injured at a school function, your private insurance will be billed first and the school’s insurance can be billed secondary. You need to obtain a form from your school completed with any claim numbers assigned to this injury. We cannot bill school insurance without this information. You will be responsible for any follow-up with the school insurance if payment is delayed.

Insurance Questionnaires – Your insurance carrier may require you to fill out an injury detail questionnaire regarding your injury. Your insurance carrier will not pay your claims until they receive this information. We will bill you for any rejected charges by your insurance carrier for this reason. It is your responsibility to make sure your insurance carrier pays your claims.

LiabilityWe do not bill any third party liability insurance under any circumstances. For example no homeowner’s insurance, injuries at other businesses, etc. We will gladly give you a copy of all the charges for your visit and you can submit yourself. You will still receive statements from us and are responsible for all charges.


Payments

Self Pay- All self-pay patients are required to make a $100.00 partial payment prior to seeing the provider. We will be happy to then set you up for a payment plan for the remaining portion of your balance.

Statements– You will receive a statement from our office for any self-pay balance due after your insurance carrier pays. After typically a third statement is sent out and we have not received payment we do then turn the balance over to our Collection Agency. We do allow a payment plan on any outstanding balances over $100.00. If you do set up a payment plan and a payment is not received on a monthly basis the account is also turned over to our Collection Agency.