Patient Center
Forms
As a convenience to our patients you may download the necessary forms or submit your patient history online below. Click on the links to open the forms OR right click on the link and select “Save Target As” to download the forms to your computer.
This will save you time and expedite your visit. Please bring the filled out forms with you at the time of your clinic visit.
Secure Online Forms
Financial
Vein Specialists of the Carolinas strives to serve its patients in a courteous and competent manner at all times
We appreciate the rising cost of medical insurance premiums for everyone along with the rising cost of living. However, perhaps you are not aware that physician fees have not been increased generally in over twenty two (22) years.
PATIENT FINANCING ARRANGEMENTS
Patient deductible, co-insurance and co-pay amount Financing
To assist our patients Vein Specialists of the Carolinas makes available:
- credit card payments
- (24) month financing plan
- Interest free financing plan for up to (6) months-some limitations apply
Vein Specialists of the Carolinas accept assignment of our patient’s insurance benefits and file claims on their behalf.
Patient – Insurance Assignment of Benefits
It is important to note that insurance companies will pay your medical provider the amount of your covered medical treatment cost at what they deem "usual and customary fees". They deduct your contract obligations from the reimbursement made to the medical providers. These deductions are:
- Annual Deductible Amounts
- Co-Insurance Amounts
- Co-Pay
This results in your obligation to pay the medical provider with these amounts in full.
USEFUL DEFINITIONS OF YOUR INSURANCE POLICY
Deductible
The amount of money you must pay annually before payments will be considered by the Insurance Carrier for any covered services. These range from $250 to $20,000. All patients are self insured up to the deductible amount on an annual basis.
Co Pay
Typically this is on a per office visit basis to both family practitioners and medical specialists.
Co-Insurance
This is expressed in terms of a percentage paid by the insurance carrier after the annual deductible/s are met by the insured party for all covered charges. Premium cost is higher for policies that call for 80/20 rather than 70/30 etc. of the approved covered treatments and fee per service cost rendered/received.
Maximum out of Pocket
This is a predetermined total maximum amount per year that an insured party will be responsible for paying based on deductible and co-insurance payments. This is most often expressed in terms of either an individual or family combination of medical expenses paid by the insured party.
Pre Existing Conditions
These are medical conditions that a carrier has determined as existing prior to their coverage effectiveness and therefore all treatments for this condition would be excluded. (not covered)
Un-Covered Services
Those medical services excluded in the contract from coverage by the Insurance Carrier.
Pre –Certification
A clause that requires that patients and providers advise the carriers prior to admitting the insured party to an inpatient status at a hospital or prior to performing any surgical procedure. Failure to do so will result in non payment for medical services.
Rules and Barriers
During this time the rules and policies adopted and imposed by Insurance Carriers regarding allowable patient treatments (when, if, and what treatments patients may have according to Insurance Guidelines) have risen to an all time level using most often "not medically necessary" as the rationale behind claim denials. In an attempt to overcome this obstacle we process written requests to your insurance carrier asking for their agreement as to the "medical necessity" of the purposed treatments prior to performing procedures.
In keeping with our desire to serve you, our patient, we additionally accept "an assignment from you of your insurance benefits" in order for us to file your insurance claim covering the cost of the medical services rendered by Vein Specialists of the Carolinas. This does not relieve you of the burden of payment should your insurance company failed to pay your claim; however, we do all that we can possibly do to effect payment.