In-network: Sensenbrenner Primary Care will file claims for in-network insurances. You are responsible for knowing your health insurance benefits, including deductibles, co-payments, coinsurance and if there are any exclusions to your policy. You are responsible for assuring that all referrals and/or authorizations are obtained for each visit. You will be expected to present a current copy of your insurance card(s) on every visit. For successful claim filing it is necessary that you provide us with accurate and current insurance and demographic information, an assignment of benefits and an authorization to release information. You certify that all information given is correct to the best of your knowledge and any changes to your information will be reported to Sensenbrenner Primary Care as soon as it is known by you. If you have insurance with a company or government agency with which we are contracted, any co-payments, co-insurance or deductibles required by your insurance company must be paid at the time of service. If you are unable to make your co-payment at the time of your scheduled appointment you may be asked to reschedule your appointment.
Out-of-network: If Sensenbrenner Primary Care is not contracted with your insurance company, payment in full for services rendered is due at the time of service. We will courtesy file a claim on your behalf and they will reimburse you directly.
Self Pay/ No Insurance on File: A patient that does not have third party coverage from a health insurer, health care service plan, Medicare, or Medicaid and does not have an injury that is compensable for the purposes of workers’ compensation, automobile insurance, or other insurance as determined and documented by SPC is eligible for a discount under our Uninsured Self-Pay Prompt Payment Discount Policy. It does not apply to patients classified as underinsured (i.e., patients who present insurance coverage that is limited or otherwise does not adequately cover the patient’s charges) or patients who have health insurance whose out of pocket responsibility is derived from a non-covered service, co-pay, coinsurance, or deductible. A $100.00 uninsured self-pay pre-payment is made prior to or during appointment check-in (pre-payment applied to balance at check-out). Payment in full must be received on the date of service during check-out. SPC reserves the right to reverse the discount if a) a potential payer source is identified, b) the patient fails to pay in full at the time of service during check-out, c) the patient’s payment by check is returned by the bank (NSF check). Services provided by outside vendors (e.g., outside lab services) are not covered by this policy and questions related to discounts should be referred to the vendor directly.
Please do not call to make payments over the phone. You can pay your bill by mail or online.