Financial Policy

Thank you for choosing our office. You can feel certain you will receive the best quality of care available.

The medical services provided by this office are restricted to the portion of medicine referred to as Family Practice, which is the practice of caring for the medical needs of the entire family.

Our office staff will be happy to discuss our fees with you prior to you seeing the doctor. We want our patients to understand our fees and feel confident that they are getting the best medical care available for their dollar. Payment in full will be requested for each visit before you leave. If you cannot take care of your bill, please see our staff prior to seeing the doctor. You will be provided with a detailed itemization of charges at the time of payment for this visit. We suggest you keep this record of your visit which will also indicate that your account is paid in full. At this time, you will be given any prescriptions that the doctor deems necessary for your health, and an appointment card as a reminder of any future appointments if needed. Your medical treatment will not be affected by your ability to pay, as your situation will be kept confidential by our staff.

• PAYMENT: Payment is expected at the time of service. If your deductible has not been met, or a percentage is your responsibility, we expect payment when services are rendered. Even though insurance will be filed, you are responsible for any balance after insurance processes your claim. All charges for treatment become due and payable sixty (60) days after the date of service. These periods allow sufficient time to process insurance and make payment in full of any remaining balance. There will be a $25 charge for returned checks. If not paid with sixty (60) days, Bruce E. Maniet, DO will begin various collection activities including, but not limited by submitting the past due account to a collection agency.
• SELF PAYMENT (PRIVATE, CASH PAYMENT): If you have no insurance coverage, we ask that you coordinate your care with our business office prior to your visit. we require an advance payment for professional services.
• MEDICARE: The provider is a participating provider with the Medicare program and accept as payment, the Medicare allowable, patient deductible and/or 20% co-insurance. If you have supplemental insurance (Medigap) to cover the portion of the charges that Medicare does not pay, please provide us with a copy of your insurance card and any forms your insurance company may require. Medicare or secondary carriers do not cover some procedures and supplies. Please make certain you understand which aspects of your treatment are covered before proceeding. In this rare case you may be asked to sign a waiver form, which states that you understand that you will be responsible for these charges.
• INSURANCE: We want to reiterate that payment for services received by you or your family members are your sole responsibility. However, as a courtesy to you, we will bill your insurance company and allow sixty (60) days for them to remit payment in full to this office. Should they not respond, deny your claim, or fail to pay a portion of the charges, you will be responsible for making full payment within ten (10) days of their response. You will be responsible for receiving an explanation of benefits from your insurance company. Keep in mind, your insurance policy is a contract between you and that company. Our patients with insurance will be asked to sign an assignment of benefits form before you leave today. This form will ensure that payment will be sent from your insurance provider directly to our office.
• SECONDARY INSURANCE: The Texas Department of Insurance requires that patient to provide secondary insurance coverage to the provider if applicable. The Patient agrees to provide such information. The Patient agrees to immediately notify the provider of any future additions, changes or deletions in primary or secondary insurance coverage.
• CHILDREN OF DIVORCED PATRENTS: Responsibility for payment for treatment of minor children, whose parents are divorced, rests with the parent who seeks the treatment. Any court ordered responsibility judgement must be determined between the individuals involved, without the inclusion of the Physician.
• LIABILITY INSURANCE PAYMENTS: If you are involved in litigation against someone for a wrongful act which brought about your medical needs today, keep in mind that you are still responsible for the payment of your account, not the person you are suing. Since legal matters can often take years to resolve, we ask that you pay your account with us promptly as spelled out in this statement. We will work with your attorney by providing all necessary documentation to him/her for the successful outcome of your action, providing the proper fees are taken care of.
• AUTOMOBILE ACCIDENT PATIENTS: We do treat automobile accident patients. However, we are unable to monitor long-term accounts and require payment as a self-paying patient. We will not accept a letter of protection from an attorney as a guarantee of payment or third-party insurance payments.
• PAYMENT PLANS: We offer the opportunity to establish a reasonable payment plan if you are not able to pay in full at the time of service. If you have an outstanding balance, we expect you to make payment arrangements before your next scheduled appointment. Non-payment on your account may result in discharge from the practice.
• MEDICAL RECORDS: Your medical records are held by this office in strict confidence. They will not be released without your explicit written permission. All requests for the release of medical records must be in writing. Since the compilation of these records takes time, a reasonable charge must be made for this. A charge of $.20 per page plus appropriate postage will be required for these services, which is not reimbursable by your insurance coverage. This payment will be payable by the person/persons requesting the transfer of medical records be it the patient, insurance company, or other entity.

Before receiving services, you must verify that we are a participating provider for your insurance company. It is also necessary that Bruce E. Maniet, DO is listed as your primary care provider with your insurance company, if required by your contract with your insurance company. In the event we are not a participating provider, Bruce E. Maniet, DO is not listed as your primary care provider with your insurance company, we will file the initial claim as a courtesy. Payment, however, is due in full at the time of service.

Failure to keep your account balance current may require us to cancel or reschedule your appointment.

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