FOOT AND ANKLE CENTER OF ILLINOIS

Thank you for choosing FACI for your podiatric care. We are committed to providing you with the highest quality specialized treatment. Please review and sign our patient financial policy below prior to treatment. If you have any questions, our billing team is happy to assist you.

1. Insurance Coverage and Patient Responsibility

   We participate with many insurance plans, including Medicare and commercial carriers; however, your insurance policy is a contract between you and your insurance company.
   • It is your responsibility to verify that our podiatrists are in-network with your specific plan prior to your visit.
   • You are responsible for any portion of the bill your insurance company does not cover, including deductibles, co-insurance, co-pays and non-covered services (e.g., orthotics, nail treatments for toe fungus, laser treatments, imaging, cosmetic services, and/or DME).
   • Bills will be sent by email and text unless specified for paper (mail).

2. Co-Payments and Point-of-Service Collections

   In accordance with your insurance network contract, all co-payments, past-due balances, and deductibles are due at the time of service. For your convenience, we accept checks and major credit/debit cards. If you are unable to provide the required copayment upon arrival, we will reschedule your appointment.

3. Non-Covered Durable Medical Equipment (DME) & Custom Orthotics

   Podiatry frequently utilizes specialized supplies, night splints, surgical shoes, and custom orthotics.
   • Some insurance plans restrict or exclude DME or orthotic coverage.
   • If your insurance denies coverage for a dispensed item, you agree to assume full financial responsibility for the retail cost of the item.

4. Non-Participation / Self-Pay Patients

   If you do not have health insurance, or if we do not participate in your network, you are considered a "Self-Pay" patient.
   • Payment must be made prior to treatment. This covers the office visit with additional procedures discounted from our usual and customary rates.
   • Pursuant to the federal No Surprises Act, you have the right to receive a Good Faith Estimate (GFE) outlining expected costs before scheduled treatments or procedures.

5. Illinois Fair Patient Billing & Collection Protections

   In compliance with Illinois law, we will always provide clear, itemized billing statements upon request.
   • If you experience a financial hardship, please contact our billing department immediately. Before any outstanding balance is referred to an outside collection agency, we will provide you with a 90-day window from the initial bill to request a reasonable, interestfree payment plan.
   • Delinquent accounts that ignore billing notices and fail to establish or maintain a payment plan after 90 days may be sent to a collection agency and may result in discharge from the practice.
   • If sent to a collection agency, you are responsible for any reasonable collection costs and attorney costs.

6. Cancellation and No-Show Policy

   We dedicate time specifically to your care. If you need to cancel or reschedule your appointment, we require at least 24 hours' notice.
   • Failure to provide 24 hours' notice or failing to show up for a scheduled appointment may result in a fee or discharge from the practice.
   • This fee, if applicable, is not covered by insurance and must be paid prior to scheduling your next appointment.

7. Finance Charges and Return Check Fees

   • You agree to pay a finance charge at the rate of 1.5% per month (18% per year) on all unpaid balances commencing 60 days from the date of service. You also agree to pay a $50.00 service charge on all returned checks.