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Billing Information

The staff at Mark D. Le M.D.,P.A. recognize that figuring out and paying medical bills can be a confusing and stressful process. In order to serve you well and avoid misunderstandings, we would like to inform you of our office billing policies.

Insurance Filing Policies

Mark D. Le M.D.,P.A. will bill your health insurance carrier as a courtesy to you. We have made prior arrangements with many insurers and health plans to accept assignment of benefits. You will be required to pay your co-insurance, co-payment or deductible at the time of service. While we are pleased to provide service to you, it is very difficult to keep track of all the individual requirements. We recommend that you contact your insurance company or human resource at your place of employment with specific questions regarding your plan benefits.

Non-Covered Services: Please be aware that many insurance plans (including Medicare) do not cover certain services such as preventive health exams (physicals). While we are happy to submit the bill to your insurance carrier, you may be responsible for payment of this type of service, in full, if it is not covered under your policy.

If any time there is a change in your insurance plan, please notify the front office staff so that your insurance claims are filed on your behalf in a timely manner.

Patient/Guarantor Responsibilities

The "guarantor" is considered to be the person who request care for the patient and who is ultimately legally responsible for the payment for medical services provided to the patient. In the case of patients who are legally competent adults, it is almost always the patient who is the guarantor themselves. It is the guarantor's responsibility to:

a) Ensure coverage is in effect at the time services are provided

b) Provide, at the time of your first visit and any time there are changes, with the correct insurance company name, policy and group numbers and other information known only to the subscriber and/or patient that the insurance carrier needs to process the bill. Our front office staff will verify and confirm eligibility at each visit if necessary. If our front staff is unable to verify patient's insurance coverage/eligibility not due to our staff's fault (i.e. insurance company system down), your appointment will be rescheduled.

c) Pay any office visit co-payment at the time of your visit.

d) Pay all balances due upon your receipt of your first statement indicating that an insurance carrier has:
     i. paid its share (i.e. deductibles, co-insurance are the guarantor's responsibility).
     ii. denied a claim for any reason (i.e. if coverage was not in effect, the service(s)
         wasn't covered, etc.)
     iii. failed to respond to our sending the claim for more than 60 days.

Patients without Health Insurance

Patients without health insurance considered as self-pay patients. Self-pay patients are expected to pay in full for services at the time they are rendered. If you are unable to pay for services in full on the day of your visit, the remaining balance is expected upon receipt of your first statement. Other arrangements can be made, please refer to our Payme nt Arrangements section below.

Worker's Compensation

For services related to on the job injuries and illness, Mark D. Le, M.D., P.A. will bill your employer's worker's compensation insurance carrier and follow all procedures as required by the worker's compensation laws. Only when it has been determined that your injury or illness is unrelated to your work will we bill your health insurance or you.

Automobile and Other Liability Cases

Mark D. Le, M.D., P.A. cannot bill third parties in liability cases due to extreme delays of payment usually associated with such cases. We may bill your health insurance carrier or treat the rendered services as a self-pay patient and you can in turn submit the medical bills accordingly.

Methods of Payments

Mark D. Le M.D.,P.A. accepts any of the following method of payments:

     a) Personal Check
     b) Cash
     c) Visa, MasterCard, Discover

Payment Arrangements

Mark D. Le M.D.,P.A. can, in certain circumstances of financial hardship, work out a payment plan for outstanding balances owed directly by guarantor. We are happy discuss your situation and try to work out a payment plan that will meet your needs. Please contact Elizabeth Kieu at (281) 255-6333.

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