Office Policy
 Co-Payments
 Waiver Of Patient Responsibility
 Non-Covered And Out Of Network Services
 Coverage Changes
 For Our Patients With No Medical Insurance
 Payment Plan
 Late Arrivals
 Appointment No-Shows
 Delinquent Balance Appointment
 Nonpayment
 Code of Conduct
11/1/2014

We would like to thank you for choosing Cardiology Associates of Princeton as your healthcare provider.
Cardiology Associates is committed to providing you with the best possible medical care. We are sure you understand that payment for this healthcare is your responsibility. The following information outlines your responsibilities related to payment and the patient-to-doctor relationship for professional services. In our age of everything moving to electronic means of documentation and communiqué’, your chart is now part of an EMR (Electronic Medical Record) system. Also, some of our communication is moving in that same direction with implementation of our Patient Portal and Appointment reminders. With these methods of communication, in our best efforts to get these results to you and/or your family member, we do not have control over the absolute of data transfer. As faxes and other forms of information transfer there are times when the system is unreliable and it is the patient’s responsibility to complete this loop of contact - please schedule a visit after test/lab is performed to review results.
Medical decisions which are beyond the scope of a call or portal message will require a visit.
Please note- it is patient responsibility to make sure contact info and HIPAA preference remains updated
We participate in most major health plans. We have contracts with many HMO's, PPO's, Medicare insurance companies and government agencies including Medicare and Medicare Managed Care. Our billing office will submit claims for any services rendered to a patient who is a member of one of these plans and will assist you in any way reasonably to help get your claims paid. It is the patient's responsibility to provide all necessary information at time of check in. As a courtesy if you have a secondary insurance we will automatically file a claim with them as soon as the primary carrier has paid. Tertiary (3 rd carriers) claims are the responsibility of the patient to file. If there is a balance after the primary and secondary pays the patient is responsible to pay this balance in a timely fashion. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request.
Please bring your insurance card with you at the time of your appointment.
If you are insured by a plan we participate with but don't have an insurance card with you, payment in full for each visit is required until we can verify your coverage.
If a patient is a member of an insurance plan with which we do not participate, payment in full is due at the time of service.
 Aetna
 Amerihealth
 BC/BS (Horizon)
 Beechstreet Network
 Cigna
 Devon Health
 Greatwest
 Guardian
 Healthnet
 Independence Personal Choice
 Medicare
 Medicare Managed care
 Medicare Railroad
 One Health/Great West
 Oxford
 PHCS/MultiPlan
 Princeton Theological
 Qualcare
 Tricare
 United Healthcare
Office Policy 11/1/2014

****We do not participate with Medicaid, Medicaid Managed Care plans, International plans, plans that may be carved out for the Affordable Health (Obama Care plans), *Worker’s Comp or
Auto Accident claims. *****
It is the policy of the practice to treat all patients in an equitable fashion related to account balances. The practice will not waive, fail to collect, or discount co-payments, co-insurance, deductibles, or other patient financial responsibility in accordance with state and federal law, as well as participating agreements with payers. Full or partial financial responsibility may only be waived in accordance with the practice's Hardship policy.
Medical services that are considered by your insurance company to be non-covered, out of network, or not medically necessary will be your responsibility.
This includes plans which require referral. It is the patient’s responsibility to know whether his/her plan requires referral for in-network benefits. This referral must be obtained by the patient and valid for the date services are rendered, otherwise payment in full for the visit is required
If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.
If you do not have group or individual medical insurance, payment /deposit of $250 is expected prior to your visit. This deposit is not the total cost of the encounter. Please note, we do offer discounted fees for patients without health insurance.
Please let us know if you are having difficulty paying your account. We may be able to help you by setting up a payment plan based on your financial hardship, call (609) 921-7456 for assistance.
Office Policy 11/1/2014

A patient who arrives more than 15 minutes after his/her appointment is considered a late arrival. A late arrival, is not considered to be the responsibility of the Practice andwill be registered and worked into the schedule as soon as possible. If the patient is more than 30 minutes late, the appointment may be rescheduled.
Any patient who fails to arrive for a scheduled appointment without cancelling the appointment at least 24 hours prior to the scheduled time is considered a "no-show". A no-show patient may be charged $40.00, as set by the Practice, for failure to show. A patient who fails to present themselves two times for scheduled appointments is considered a chronic no-show. A patient who is a no-show four times may be dismissed from the Practice.
Patients with a delinquent balance are required to make payment in full for future services. A delinquent account is defined as a patient balance in excess of 120 days if the patient has not made any payments or sought assistance via financial hardship during this time If we have to turn your account over to collection, you may be charged an interest rate on the outstanding balance from the date your bill was due, not to exceed the national standard average and you may be responsible for all costs and expenses of collection including, but not limited to our reasonable attorneys’ fees
If such payment is not made, the practice has the right to excuse the patient from the practice.
All patient responsible balances that remain delinquent after 90 days, with no response to our requests for payment, may be referred to a collection agency.
If a co-payment is not paid at Time of Service there will be a $10 processing fee to bill the patient or responsible party.
For return or insufficient fund checks there will be a $30 charge.
For Echo cd’s there is a $20 charge at time of pick up.
Please be aware that if a balance remains unpaid, you and/or your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.
Office Policy 11/1/2014

The doctor –patient relationship has been and remains a keystone of care: the medium in which data is gathered, diagnoses and plans are made, compliances are accomplished, healing, patient well being; confidentiality, respect and support are provided. With these key factors being the forefront of our core values we expect the same respect and consideration from our patients when interacting with our staff and/or providers We have made a firm commitment not just to the patient, but to our staff that no form of verbal abuse, cursive language, threats or acts of threats will be tolerated and we reserve the right to terminate the offending party. If a patient reaction is one which is found to be offensive, Cardiology
Associates reserve the rights to terminate the doctor-patient relationship.
Thank you for understanding our financial and office policy. Please let us know if you have any questions or concerns.
Office Policy 11/1/2014