Financial Responsibility

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RUPINDER K. MANN, M.D.

Board Certified in Internal Medicine and Geriatrics

To our Patients:

As you know if you have ever checked into a hotel or rented a car, the first thing you are asked for is a credit/debit card, which is imprinted and is an alternative used to pay your bill.

This is an advantage for both you and the hotel or car rental company, since it makes checkout faster, easier, and more efficient.

We have implemented a similar policy, effective August 1, 2015. You will be asked for a credit/debit card number at the time you check in and the information will be held securely until your insurance company has paid its portion and notify us of the amount of your share. At that time, our office will make an attempt to contact you to inform you of your insurance company’s determination of payment. If we do not hear from you within the next 3 business days, we will proceed to charge your credit/debit card for any remaining balance owed by you.

This will be an advantage for you, since you will no longer have to write out and mail us checks. It will be an advantage for us as well, since it will greatly decrease the numbers of statements that we have to generate and send out. The combination will benefit everyone in helping to keep the cost of health care down.

This in no way will compromise your ability to dispute a charge or question your insurance company’s determination of payment.

If you have any questions about this payment method, do not hesitate to ask for the Office Administrator.

Thank you,

Rupinder K. Mann, M.D.

    *Signature#:

     

    *Please be prepared to show credit/ debit card to out registration clerk*