Primary Insurance

The first insurance to be billed according to industry rules and the terms and conditions of your insurance plan.

Menlo Medical Clinic will bill the patient's primary insurance carrier for all services. The   primary insurance carrier will typically make payment to Menlo Medical Clinic in accordance to your benefit plan.

The billing office will submit bills to the patient's insurance plan if the patient has supplied us with current and correct information. Our policy is to allow the insurance carrier 60 days to pay a claim. If a payment has not been received from an insurance carrier within 60 days we may request the patient's assistance in working with the insurance carrier for payment.

The insurance carrier is a contract between you, your employer and your insurance company. It is in your best interest to know and understand your plan benefits, as well as any deductible and co-payment amounts that you are responsible for paying.

Insurance payments vary depending on what type of insurance you have and how the payer determines payment. Some plans pay at a contracted rate, some plans will look at the range of fees within the community and some plans will pay on a predetermined fee schedule regardless of the amount charged.

Not all services are covered in all insurance contracts. If your insurance plan does not cover a service or procedure, you are responsible for these charges.

Managed Care

Refers to a variety of approaches to managing health care, from a standard indemnity plan to health maintenance organizations.

The focus of managed care is usually on controlling health care costs. This is accomplished in a number of ways, including contracts with specific providers, incentives to those providers to keep costs down and a review process to prevent the use of unnecessary health services.

Medicare

If you are a Medicare patient, Menlo Medical Clinic will prepare and submit your claims to Medicare on your behalf.

Menlo Medical Clinic accepts Medicare assignment of benefits; this means that Menlo Medical Clinic will accept the amount that Medicare allows.

After Medicare payes their portion of what they allow, Menlo Medical Clinic will bill you directly for the remaining balance.  Menlo Medical Clinic does not provide billing to your supplemental insurance. You will be responsible for payment of the balance, after Medicare pays, within thirty (30) days of our billing to you.

Medicare patients may call these phone numbers for assistance:

• Part A: (866) 380-4745 - Administered by United Government Service
• Part B: (800) 952-8627 - Administered by National Heritage Insurance Company
• HICAP: (800) 200-0268 - Health Insurance Counseling & Advocacy Program

Self-Payment or Self-Pay

Menlo Medical Clinic requires a $100.00 deposit at the time of service for all self-paying services.  

Worker Compensation

Worker Compensation provides insurance-type coverage for work-related illnesses and accidents. In order to use this insurance you must provide the appropriate insurance information, employer information, claim number and date of injury.