Financial Policy and Consent

As a courtesy to patients Monarch Allergy Medical Services of New York, P.C. and Monarch Allergy Medical Services of Florida, P.A. (collectively, “Nectar Allergy Center”) verifies insurance coverage and benefits before a patient’s first visit, annually, and/or when insurance coverage changes. A quote of benefits is not a guarantee of benefits or payment. Claims will process according to each patient’s plan benefits. If the insurance company pays differently than estimated for any reason, the patient/responsible party agrees they are responsible to pay any remaining balance within 30 days of notification of the balance. If after 60 days from filing a claim, payment has not been received from a patient’s insurance carrier, we may ask patients/responsible parties to pay the remaining balance on the account. Although we do our best to advocate for our patients and assist with benefits and eligibility, it is ultimately the patient’s responsibility to know and understand their specific medical insurance coverage and cost shares.

** We highly encourage patients to contact their insurance carrier and check into their policy’s benefits for allergy, asthma and immunology coverage. **

If during the benefits investigation it is noticed a patient has an unmet deductible, a deposit toward services rendered will be collected at the time of service. A Nectar Allergy Center representative will contact and explain this information to patients prior to their visit. Patients will be billed for any outstanding balances from visits and services rendered once insurance processes the claim. Balances are due to be paid within 30 days of notice of the balance. Further actions may be taken on any account not paid in full after the 30-day grace period. It is the policy of Nectar Allergy Center that all patients pay their deposit, copay and/or coinsurance payment at the beginning of each visit.

As a courtesy, Nectar Allergy Center will bill insurance on patients’ behalf. In order to do so, we ask patients to provide insurance information to the front office staff at each visit to ensure accurate billing of claims. We do require a photocopy of insurance cards to be on-file, as well as all required information regarding the policy holder of the insurance plan(s) in which we are billing. Please note: accepting insurance does not place all financial responsibilities onto Nectar Allergy Center, and the patient/responsible party will be held accountable for any unpaid balances by a patient’s plan.

Although we are contracted with many insurance carriers, our services may not be covered by a patient’s specific insurance plan. Being referred to our clinic by another physician does not necessarily guarantee insurance will cover services rendered. Please remember that the patient/responsible party is 100% responsible for all charges incurred: a physician's referral and our verification of insurance benefits are not a guarantee of payment.

It is the patient’s responsibility to ensure Nectar Allergy Center has the current/active insurance(s) and updated mailing address on file, as well as other demographic information. Failure to do so may result in delayed claims processing or failure of receiving notifications of balances and other important information. Nectar Allergy Center will not be held responsible for having outdated information on-file. Nectar Allergy Center will not retro-authorize or process claims if updated insurance information is not provided to our staff prior to services being rendered.

Method of Payment

We accept cash, checks and most major credit cards. Returned checks are subject to a $25 NSF fee to the patient and the Company will no longer accept checks from patients who have written a returned NSF check. These patients will be asked to pay in another accepted alternative form or payment such as money order, credit card or cash for all future transactions.

No Insurance Coverage

For patients without insurance coverage, payment-in-full at the time of service is required. The front desk staff needs to be notified by the patient prior to an appointment when cash will be paid for services rendered.

Usual & Customary Rate

Our clinic is committed to providing the best treatment possible to our patients. We charge what is usual and customary for our area. Patients/responsible parties are responsible for paying any balance in full, regardless of the insurance company’s determination of usual and customary rates. If an insurance does not cover a specific treatment or service, patients will be offered cash price rates to consider. In some cases, a cash price membership may be available. Staff members can provide more information regarding specific situations and treatment plans.

Coordination of Benefits

Nectar Allergy Center is willing to bill more than one insurance on behalf of a patient, but the patient is responsible for coordination of benefits. If a patient has more than one insurance, it is the patient’s responsibility to ensure all plans involved are aware of one another and the sequence of primary versus secondary is clear to all parties involved with the billing process. When issues arise related to this matter, it is the patient’s responsibility to correct this with the payers and inform Nectar Allergy Center billing staff when it is resolved. Any unresolved problems in this regard may result in unpaid balances that will become patient responsibility if not resolved within 90 days of first claim submission date.

Appointment Cancellations and Electronic Communication

A 24-hour notice is required for change of appointment requests or cancellations. This will allow staff to try and fill the vacancy with another patient requesting services. Failure to comply may incur a $100.00 fee. We appreciate our patients and cooperation in complying with this policy and will assist us in providing the best care possible to all of our patients.

I have reviewed and understand all content on this document.

Billing Communication

There are occasions when one of our staff members will need to verbally contact you regarding your account. On the chance we are unable to reach you and get a voicemail, we ask that you check the appropriate box where you prefer to be contacted, including the number to call. This will allow us to leave more detailed information in our message to you. Please note this is only an authorization to specify what information we are allowed to leave on your voicemail if you do not answer when we call.

Patients over the age of 18 are ultimately responsible for any debt accrued on their account unless we have written authorization and acknowledgement from a third party accepting financial responsibility. For adult patients whose parents will be responsible for paying any debt accrued on the adult child’s account, we require a specific form to be completed by the patient and parents. Without this written authorization we cannot discuss account details with anyone other than the patient. Please ask the front desk staff for the proper forms for this situation, if needed.

I authorize the following and I understand I can opt out at any time by submitting a written request:

A Nectar Allergy Center representative is authorized to leave a detailed voice message regarding my account on my preferred number.

* This authorization DOES NOT authorize named individual(s) to have any discussion regarding the patient’s protected health information unless it directly relates to billing. Only as-needed information is disclosed