Insurance

What Insurance Plans Do We Accept?

The Adkins Headache Clinic, PLLC accepts most major PPO/POS insurances such as Aetna PPO, Blue Cross Blue Shield (BCBS), Cigna, Humana, United Healthcare PPO, etc. We do accept Medicare, but we do not accept HMO, Medicaid or third-party liability insurance. Please contact your insurance company for eligibility and benefits prior to contacting us.

Our Insurance Procedures

We will bill your insurance company for your initial office visit. Any co-pays and/or deductibles are due at the time of service. If you are out of network, we will not bill insurance companies for follow-up visits unless we are contracted with them or you have Medicare. Although eligibility has been checked with your insurance company prior to your office visit, this is not a guarantee of payment. Your insurance company determines benefits once the claim has been received and reviewed.

If your insurance company was billed and payment is not received within 45 days, the balance will be transferred to the patient’s responsibility. Our office cannot accept responsibility for collecting your insurance claim or for negotiating a settlement on a disputed claim. Any portion of the bill not paid or denied by the insurance carrier will be the patient’s responsibility.

If you have Medicare and a supplemental or secondary insurance carrier, please call Medicare and advise them of your secondary or supplemental information. Medicare will bill your secondary carrier for you.

We do not bill secondary insurance carriers unless Medicare is your secondary insurance or we are contracted with the secondary insurance carrier. Use the explanation of benefits (EOB) from your primary insurance carrier to bill your secondary insurance and attach any appropriate documentation, such as a statement from the Adkins Headache Center.

Our Financial Policy

Insurance Billing and Payment

  • The Adkins Headache Clinic, PLLC will bill your out-of-network insurance company for your initial office visit only. Any co-pays and/or deductibles are due at the time of service.  We DO NOT bill insurance companies for follow-up visits unless we are contracted with them or you have Medicare. Although eligibility has been checked with your insurance company prior to your office visit, this is NOT a guarantee of payment. Your insurance company determines benefits once the claim has been received and reviewed.
  • If your insurance company was billed and payment is not received within 45 days, the balance will become the patient’s responsibility. This office cannot accept responsibility for collecting your insurance claim or for negotiating a settlement on a disputed claim. Any portion of a bill not paid, or denied by the insurance carrier will be the patient’s responsibility.
  • If you have Medicare and a supplemental or secondary insurance carrier, please call Medicare and advise them of your secondary or supplemental information. Medicare will bill your secondary carrier for you.
  • We DO NOT bill secondary insurance carriers unless Medicare is your secondary insurance or we are contracted with the secondary insurance carrier. Use the Explanation of Benefits (EOB) from your primary insurance carrier to bill your secondary insurance and attach any appropriate documentation (i.e., statement from the Adkins Headache Clinic, PLLC).
  • Upon receipt of payment from your insurance company, you will receive a statement from us showing your balance due. Payment is expected within fourteen (14) days. For your convenience, we accept Visa, MasterCard, Discover and American Express. You can also apply for Care Credit, which offers interest-free, low monthly payments if you qualify. Please contact our office for information.
  • If payment IN FULL is not received, you may be charged a $15 re-billing fee each time we issue a statement on an outstanding balance over 30 days.
  • If your bill is not paid and is transferred to our professional collection agency, then your information, which may include but is not limited to, your name, address, phone number, social security number, employment and employment phone number, will be provided to the collection agency.
  • If your insurance company requests a claim form, fill out your portion of the form and attach a copy of your itemized statement provided by our office. A physician’s signature is not required. It is not necessary for our office to fill out the “Attending Physician’s” portion of the claim. The statement is authentication in and of itself.
  • You must inform our office if you have a new insurance carrier or if the insurance carrier has relocated to a new address. Please send us a copy of the front and back of your new insurance card so we can update our records. Failure to do so may result in delayed claims and/or responsibility for unpaid claims.
  • Please note that this office does not accept HMO, Medicaid, Workers Compensation or any forms of public aid.

Completion of Forms

  • You are advised that this office charges at least a $50 fee per form fee for any forms completed on a patient’s behalf. This includes, but is not limited to, disability forms, Family Medical Leave forms, Attending Physician’s forms, itemization of charges, etc.

Medical Records Requests

  • Please be aware that if you request medical forms, this service will be outsourced to our medical records vendor upon completion of your release form.

Initial Office Visit Fees

  • The cost of the basic initial visit, which includes a neurological examination, ranges between $200 and $400. Laboratory tests are usually required and typically include CMP, CBC, TSH, Urine Drug Screen and an EKG. Charges for these tests are in addition to the initial office visit charge. Total charges usually range between $500 and $1,000.
  • If any of these tests were done within the past year, or you have undergone a CT scan or MRI of the head or neck, please bring the reports with you, as the tests may not have to be repeated. Other tests may be required and would involve an additional charge.

Appointment Cancellation Fee

  • If you are unable to attend your scheduled appointment, please notify our office at least 24 hours in advance. Failure to do so will result in a cancellation fee of $75.

General Note

  • This office reserves the right to change its fees at any time without prior notice.

Billing Contact Information

Please call our office at (919) 907-2377 with any billing issues or concerns.