Prior Authorization | Mgd Care | Medicare | Medicaid | Workmans Comp | Claim Forms

Insurance

Health Insurance
Fees are determined by multiple factors including: complexity of the problem, review of symptoms, physical findings and x-rays, and the type of treatment. You are advised to check with your carrier regarding benefits and authorization guidelines.

Health insurance plans vary considerably in their benefit coverage. Failure to verify your carrier’s coverage may result in a reduced insurance payment and a higher cost to you. Our staff will assist you in obtaining this information if necessary. ING will make every effort to obtain full payment from the insurance carrier on your behalf. If your insurance does not pay the entire fee, you are responsible for paying the balance in a timely manner.

Patients are expected to pay their co-payment for office visits at the time of service. Medical expenses for auto accidents are not routinely covered by your health insurance; therefore we must request payment at the time of service. We will ask you to sign a release of information and an assignment of benefits. These forms allow us to bill your insurer directly and provide the information needed to process your claim. Our office will prepare and submit a claim for you. Patients with an open balance will receive a monthly statement until the account is resolved by your insurance and/or personal payments. Following settlement with the insurance company, you are responsible for the remaining balance.

If payment presents a financial hardship, or if you have no insurance, please contact Patient Account Services at 317-396-1300 ext. 2998 (or toll free, 888-225-5464 Ext. 2998) to establish a mutually agreed upon payment plan.

Prior Authorization
Most insurance plans require “pre-authorization,” “pre-certification,” or “second surgical opinions” before they will approve some tests, procedures, and hospitalizations. Please check your insurance card for that information or call your carrier for directions. It is your responsibility to notify our office whenever prior authorization or a second surgical opinion is required. If you receive an evaluation or treatment without pre-certification, your insurance may refuse to pay your bill. We will assist you in obtaining pre-certification for any test, therapy, or surgery. However, patients are ultimately responsible for contacting their insurance carriers to ensure that prior authorization has been received.

Managed Care Programs
ING participates in most HMO, PPO, and POS programs. HMO and POS programs may require a referral from your primary care physician (PCP). Please obtain this referral form from your PCP and bring it with you to your appointment. The referral form may also be faxed to ING by your PCP. ING cannot treat patients without authorization from their primary care physician because we will be penalized by the HMO or POS.

Medicare
ING accepts assignment on all Medicare patients. Please provide us with information regarding any supplemental insurance you have. We will submit the claim to Medicare for you. Once payment or denial has been received from Medicare, we will bill your supplemental insurance for the balance of the claim. After payment or denial has been received from your supplemental plan, we are required by law to bill you for any deductibles or coinsurance amount.

Medicaid
Please present your current Medicaid card each time you are seen. At the time your appointment is scheduled, please notify us of your primary medical provider (PMP). If you participate in a Medicaid managed care program, a referral will be required from your PMP; without it, your appointment will have to be rescheduled. ING will prepare and submit your Medicaid claim. If you are involved in a “spend down” program and your deductible has not been met, we must by law bill you for those charges.

Workers’ Compensation Claims
Please provide us with the name of the work comp carrier, address, claim number, contact person, and phone number at the time the appointment is scheduled. If your employer has not authorized your visit, you will be expected to pay for your visit at the time of service.

Claim Forms
Disability, family medical leave, or loss-of-time claim forms will be completed by ING upon payment of a nominal charge. Please fill out your portion of the form and deliver or mail it to our office with a check or money order attached.