803.457.7000

Financial Policy

If you need assistance with an insurance or billing matter, or have questions, please contact our Billing Department between 8:30am and 4:30pm Monday through Thursday at (803) 457-7000 Option 5.

We are excited to be your healthcare provider and thank you for putting your trust in Southern Urogynecology.

 

We are committed to the success of your medical treatment and care.  It is important that you have a clear understanding of our Financial Policy, which is an agreement between the practice and the patient or guarantor.  At the time of your appointment, we will require a signature to document that you have read and understand our policy.  Prompt payment of charges incurred helps us keep our fees down, so we hope that you will take a moment to familiarize yourself with our financial policies.

 

Insurance

 

We participate with many insurance plans, and will bill those plans as a courtesy to you.  You are expected to pay your co-payments,  estimated co-insurances and deductibles at the time of service.  After filing, if we have not received payment from your insurance company within 45 days, you may be expected to pay the balance in full.  Our contract is with you, the patient.  Accordingly, it is your ultimate responsibility to make sure the balance is paid, whether by you or your insurance company.

 

Non-Insured Patients

 

If you do not have health insurance we are happy to see you as a Self-Pay patient.  Please be aware that payment in full is required at the time services are provided.

 

Referrals and Authorizations

 

Southern Urogynecology does not require a referral from your primary care physician for you to be seen or treated as a patient.  However, your insurance plan may have its own specific requirements.  Please be sure you know what your plan requires.  If you are uncertain, we recommend you talk with Member Services  to determine their requirements.  If you are enrolled in an HMO (Managed Care Plan), your plan may require a Referral (authorization) from your Primary Care Doctor.  Without this referral, the insurance company will not pay claims for our services.  Obtaining this referral is your responsibility.   Make sure to check with your primary care doctor and verify that the referral has been sent to out office before you are seen.   Failure to have the necessary referrals in place could result in cancellation or rescheduling of your appointment.  As always, referrals are not a guarantee of payment.  Retroactive referrals (those obtained after your appointment) are not guaranteed by the carrier.

 

Co-Pays, Deductibles, Co-Insurance and Predetermination of Benefits

 

Payment is required at the time services are rendered unless other arrangements have been made in advance.  This includes applicable co-payments, estimated co-insurance amounts and unmet deductibles.  Please remember, patient responsibility amounts are determined by your insurance carrier – not Southern Urogynecology.  These amounts are part of your contract with your individual insurance plan.  Accordingly, we can not waive or reduce these amounts.  For your convenience, we accept cash, checks (in-state only), VISA, MC and American Express.

 

Returned Checks:

 

There is a $30.00 service charge for checks returned by your financial institution for any reason.  Returned checks not paid within five (5) business days are subject for transfer to the local Solicitor’s office for collection.  If you write a check that is returned, your account will be placed on a “cash only” basis.  This means we will only accept cash or credit card payments.

 

Past Due Balances

 

Statements are mailed out by the 10th of each month and as payment is received from the insurance career (whichever comes first).   If you have a zero balance on your account you will not receive a statement.  Once all insurance payments have been received, you will receive a statement that shows your current responsibility.  Balances not paid within thirty (30) days are considered past due.  If  your insurance company has not responded to a claim submitted for payment, we may ask you to contact them.  Often insurance carriers need to update information from you; or they may have questions for you regarding other coverage.  Your timely response to these inquiries will help speed up the payment process and reduce the potential of your being billed for the charges.  Patient Balances that are not paid within ninety (90) days from the date of service may be forwarded to a collection agency.  For your convenience, please visit our Online Payment Portal to pay your bill.  Collection agency fees or other associated legal fees may be added to the account if a collection action becomes necessary.  Patients with past due balances will be required to make suitable payment arrangements before additional services can be scheduled.  We realize that financial difficulty is a reality and offer several payment options including payment plans for extenuating circumstances.

 

No Show and Cancellation Fees

 

Broken appointments represent a cost to us, to you and to other patients.  Cancellations are requested 24 hours prior to your scheduled appointment time.  We reserve the right to charge for missed or late-canceled appointments.  The fee for missed or late-canceled appointments is $20.00.  Excessive abuse of scheduled appointments (missed or late arrival) may result in dismissal from the practice.  Our current policy is that on the 3rd no show or missed appointments, patients are to be dismissed form the practice.  Someone from our office will call to confirm  your appointment approximately 2-3 days in advance.  If we can not reach you in person, a message will be left when possible.  If you receive a message to confirm your appointment, please make sure to contact our office to verify that you will be here for your appointment.   If you have a change in your phone number or contact information anytime in between appointments, please remember to provide us with this new information.

 

Because canceled appointment slots for certain office procedures are difficult to fill without adequate notice, and require the ordering of  specific supplies, a $100.00 fee will be charged for missed or late canceled procedure appointments.

 

Non-Emergent Appointments

 

We reserve the right to reschedule non-emergency appointments if there is a past due balance on your account, or if a co-payment is not made at the time of service.  Please plan accordingly.

 

Dismissal Process

 

Occasionally it may be necessary to dismiss a patient from our practice.  Possible reasons for this decision are;  failure to keep scheduled appointments, verbal or physical abuse towards staff members, or failure to meet financial obligations.  If this occurs, you will receive a certified letter notifying you of this decision mailed to your last address on file.  If you have a medical emergency within thirty (30) from the date of the letter, one of our providers will be available to assist you.  Once the thirty (30) day period has expired, you will no longer be seen at our practice. A copy of your medical record will be forwarded to your new physician after a written request is made and applicable fees (if any) are paid.

 

Refunds

 

If you have a credit on your account, we will gladly refund this amount to you within thirty (30) days of your request.  All request will be reviewed and approved by the Billing Specialist and Practice Administrator.  Refunds can only be made after all insurance claims have been paid.  If the credit on your account is the result of an insurance overpayment, funds will be returned to the carrier who made the payment.  No insurance over-payments can be refunded to the patient.

 

Credit Card Processing

 

Disputes and Chargebacks:

 

If a patient believes their card was over charged, or charged in error, they should contact the Billing Office immediately.  Southern Urogynecology will research the potential error, and provide a copy of all documentation supporting the transaction.  If it is determined that the card was indeed overcharged or charged in error, the disputed amount will be refunded to the card that was used by Southern Urogynecology within three (3) business days.  Please understand that we have no control over how long the credit card processing company or bank takes to process the transaction, but generally, any refund should show back on your card within seven (7) to ten (10) business days.

 

If Southern Urogynecology can provide, and believes that the transaction was conducted accurately and believes we are entitled to the funds, any additional dispute will need to be handled through your issuing credit card company or bank.

 

A chargeback occurs when a customer has disputed a credit/debit card transaction and the practice has either not been able to supply documentation to substantiate the transaction or has not done so on a timely basis.  By law the cardholder has two years to file a dispute.  Once a cardholder files a dispute, the issuing bank makes an investigation into the complaint.  IF the transaction proves to be unauthorized, fraudulent or otherwise inaccurate, the bank will refund the disputed amount to the cardholder.  If this occurs your account with Southern Urogynecology will be adjusted accordingly.

 

Any adjustment made by a credit card company, bank or processor does not necessarily relieve the patient or account holder from responsibility of the payment in question.  This will be determined on a case by case basis.

 

Response to a Security Breach:

 

In the event of a breach or suspected breach of security, including the suspicion that payment card data has been exposed, lost, stolen, or misused by any action of Southern Urogynecology or its staff, the billing office of Southern Urogynecology will immediately contact the Practice Administrator and appropriate measures will be taken to contain the breach, and notify any effected card holders.

 

Any questions, concerns, or disputes should be directed to the Billing Office at (803) 457-7000, Option 5, or to the Practice Administrator, Option 6.  You may also send an email with details regarding the dispute to twinkle@southurogyn.com, or mlambries@southurogyn.com.

 

After-Hours Coverage, Triage and Prescription Refills

 

After Hours

There is always a provider on call after hours, weekends and on holidays. However, this service is reserved for EMERGENT issues that can not wait for regular business hours. Examples of non-emergent matters may include prescription refills, questions about a bill or disability forms, or requests to schedule an appointment.

 

If you are not an existing patient of Southern Urogynecology, and you have a medical issue that requires treatment, please understand that our providers can not diagnose and treat you over the phone. You will be asked to go to an Urgent Care or the Emergency Room. You are welcome to follow up with us during regular business hours by calling our office (803) 457-7000 Option 1 and scheduling a new patient appointment.

 

After Hours Fee May Apply

If you choose to utilize our After Hours Triage service and your concerns are determined to be non-emergent, or not medical in nature, you will be charged a $25.00 after hours fee. This charge is not billable or payable through your insurance company and is considered patient responsibility.

 

Triage & Phone Calls

Every effort is made to return patient calls the same day. However, Due to the high volume of calls received in the clinic, please allow up to 48 hours for your call to be returned. Phone messages are checked several times during the day, and if you have an urgent medical matter your call will be escalated.

 

Post operative patients will receive a return call that same day as long as the message is left before 4:00. If it is after 4:00 you will need to reach the on-call provider by dialing (803) 457-7000 and pressing *7.

 

Prescription Refills

Please be aware that we cannot provide prescription refills after hours, over weekends or holidays. Please make sure you submit these requests at least 48 hours (2 business days) in advance of your need for refills. If your prescription requires a Prior Authorization, please know these can take up to two weeks for completion depending on your insurance company.

115 Midlands Court, West Columbia, SC 29169

office: 803.457.7000

fax: 803.457.7001

Monday – Thursday:

8 a.m. – 5 p.m.

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