Independently Owned and Operated since 2004

Balances on Accounts

After your insurance has paid (or denied) your visit, there may be a balance remaining. We will send you a statement monthly for any balance due on your account.* Any patient who owes a balance on his or her account must be prepared to pay the balance due upon arrival at his or her next appointment. Failure to do so can result in cancellation of the scheduled appointment. If you are unable to pay the balance in full, you need to contact the office as soon as possible to make arrangements. Unpaid balances over 90 days will incur a $5.00 monthly account maintenance fee (beginning with the 4th statement).

*Once an account is transferred to “internal collections”, statement activity will cease.

Payment/Statement Options

In-network: After your insurance has paid (or denied) your visit, there may be a balance remaining.  We will send you a statement monthly for any balance due on your account..

Out-of-network:  As a courtesy, we will file your claim, but will collect payment in full at the time of check-in.  Other services rendered after check-in will be settled at standard fee rates before leaving. By making pre-payment, patient understands and accepts risk of dismissal for non-payment/non-compliance.

Self Pay/ No Insurance on File: Prepayment of $100 to be paid at check-in with balances settled after rendered service(s).  The patient accepts risk of dismissal for non-payment/non-compliance.

Please do not call to make payments over the phone. You can pay your bill by mail or online.

ACH Check Conversion 

When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic funds transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic funds transfer, funds may be withdrawn from your account as soon as the same day you make your payment, and you will not receive your check back from your financial institution.

Returned Checks

Sensenbrenner Primary Care will charge $25.00 for any returned checks. Payment in full (amount of check + $25.00 fee) is due ten (10) days after we contact you regarding the check. Payment on returned checks must be paid with cash, Visa or MasterCard only. We will not accept a check to cover the returned check. Repeat offenders will not be permitted to pay with checks. We also reserve the right to dismiss repeat offenders from the practice.

On-Call Service

Sensenbrenner Primary Care offers an on-call service for its patients the days and evenings the office is closed. This service is for established patients and is to be used for serious medical concerns only. The on-call service WILL NOT do the following: refill medications, phone in narcotic medications, or answer non-critical medical questions (i.e. check on referrals, discuss test results or medical conditions). Persons who abuse the on-call service with non-clinical inquiries may be subject to a charge.

Missed Appointments 

If you cannot keep your appointment, you must cancel 24 hours prior to your scheduled appointment. As a courtesy, we will attempt to contact you two business days prior to your appointment to remind you. However, it is ultimately your responsibility to keep up with your appointments. Missed appointments or appointments canceled with less than 24 hours’ notice will incur a $50.00 fee. You may be dismissed from the practice for excessive no-shows or cancels with less than 24 hours’ notice.

Formulary Benefits Data 

Formulary benefits data are maintained for health insurance providers by organizations known as Pharmacy Benefits Managers (PBM). PBM’s are third-party administrators of prescription drug programs whose primary responsibilities are processing and paying prescription drug claims. They also develop and maintain drug formularies, which are lists of dispensable drugs covered by a particular drug benefit plan.  Sensenbrenner Primary Care will access my pharmacy benefits data electronically through RxHub.

This allows us to:

1) Determine the pharmacy benefits and drug co-pays for a patient’s health plan

2) Check whether a prescribed medication is covered (in formulary) under a patient’s plan

3) Display therapeutic alternatives with preference rank (if available) within a drug class for non-formulary medications

4) Determine if a patient’s health plan allows electronic prescribing to mail-order pharmacies, and if so, e-prescribe to these pharmacies

5) Download a historic list of all medications prescribed for a patient by any provider.