Clearwave Financial Policy
In-Network:
1. To the extent Clearwave has an in-network agreement with your insurance company, you may be responsible for the payment of deductibles, copays, and co-insurances (collectively, "Cost-Sharing Payments"). You are responsible for paying these Cost Sharing Payments at the time of service.
2. In addition, you hereby authorize Clearwave to bill your insurance company for services provided and for your insurance company to pay such sums directly to Clearwave.” If your insurance company remits such payment to you directly, you shall redirect such payment to Clearwave as soon as possible. This authorization shall remain in full force while you remain a patient with Clearwave unless you revoke this authorization by providing written notice to Clearwave revoking same. You also understand that your health information and records will be used, as needed, to obtain payment for your health care services from my insurance company. This may include certain activities Clearwave's staff may need to undertake before your insurance company approves or pays for health care services recommended for you, such as determining eligibility of coverage for benefits, reviewing services provided for you for medical necessity, and undertaking utilization review activities.
3. Payment is subject to the terms of your health plan at the time services are delivered and benefit limitations and/or exclusions. Any estimates provided by Clearwave for your out- of-pocket costs are only provided as a courtesy and Clearwave cannot guarantee that the estimated out-of-pocket cost will be equal to amount you actually owe under your insurance plan. You are responsible for all Clearwave charges for your care.
Out-of-Network:
1. For self-pay and out-of-network care, payment is due in full at the time of service. Please be aware that our charge to insurance may differ from our charge for self-pay patients and the amount your insurance company approves may differ from our actual charge. You are responsible for payment of our actual charge.
2. If coverage for services is denied and you would like to appeal the denial, your insurance carrier may require a letter of medical necessity. We will provide you with a letter upon request.
Cancellation Policy:
1. Any cancellations and/or rescheduling of appointments must be done at least 48 hours in advance of your appointment. Patients who cancel and/or reschedule with less than 48 hours notice or do not show for their appointment will be charged a $100 cancellation fee. Monday appointments must be canceled by noon of the preceding Friday.
2. Clearwave, in its sole discretion, may choose to waive or reduce certain cancellation fees for extenuating circumstances, however, any waiver or reduction in cancellation fees shall not be deemed a change in the Cancellation Policy and Clearwave reserves the right to enforce its Cancellation Policy on all subsequent missed appointments. Please be advised that most insurance companies do not reimburse for missed appointments and therefore you will likely be personally responsible for any assessed cancellation fee.
3. While Clearwave attempts to always provide appointment reminders, these are done only as a courtesy and failure to receive an appointment reminder does not excuse a late cancellation or a no-show.
4. Clearwave may, in its discretion, suspend or terminate non-urgent care, where permitted by law, for repeated cancellations or no-shows, or failing to pay assessed cancellation fees.
Medicare
1. For patients with Medicare plans, Clearwave will bill Medicare directly for covered services. You are responsible for all Cost-Sharing Payments and payment for any services for which Medicare denies coverage, except as prohibited by law.
Managed Medicaid
1. Clearwave participates with some, but not all, Managed Medicaid Plans. If Clearwave participates with your Managed Medicaid Plan, Clearwave will bill your Managed Medicaid plan as required. You are responsible for providing accurate and up-to-date plan information. If the intended services are not covered by your Managed Medicaid Plan, Clearwave may require a private pay agreement before providing additional, non-emergency services, as required by law.
2. In accordance with New York State law, Clearwave will only charge Medicaid patients for their required Cost-Sharing Payments, if any, for covered services while a valid Medicaid plan is in effect.
Payment Requirements:
1. Clearwave accepts payment in the following forms: (i) credit card; (ii) debit card; (iii) ACH payment; and (iv) check. Clearwave encourages but does not require patients to keep a valid credit or debit card on file to streamline billing and reduce delays in payment. Maintaining a card on file is voluntary. Patients who decline to keep a card on file will not be charged additional fees, denied care, or penalized solely for that decision. Patients may revoke their authorization for Clearwave to charge their credit card or change their card on file at any time. Notwithstanding, patients remain responsible for timely payment using any accepted payment method. Clearwave assesses applicable charges to patients on the day of the patient’s scheduled appointment.
2. Clearwave reserves the right to assess penalties for a patient’s failure to pay their outstanding balances timely. Returned checks will be charged the entire amount plus a $45 return check fee. Late payments will be charged interest at the rate of 1% per whole or partial month the payment is overdue, or 5% of the total bill, whichever is greater.
3. If a patient fails to timely make required payments, Clearwave reserves the right to suspend or terminate non-urgent care, where permitted by law, and pursue any and all means to collect outstanding payments. If Clearwave incurs any attorneys’ fees and costs in its collections efforts, you shall be responsible for reimbursing Clearwave for all attorneys’ fees and costs incurred to the extent permitted by law. If any collection efforts proceed to court, this provision shall be interpreted as a prevailing party fee provision.