Dear Patient:

Employers with Managed Care Health Plans such as Mountain State BC/BS, CIGNA and numerous others have the option of customizing benefit plans for their employees. Therefore, all benefits are not alike and you can no longer assume that all medical services will have a covered benefit.

We are considered "specialists" so your plan may require that you first seek treatment from or be referred to us by your Primary Care Physician (PCP) or family doctor. Recommended treatment plans and surgical procedures may require prior authorization. It is your responsibility to obtain prior authorization or precertification prior to your visit.

We are aware that insurance is very confusing so we would like to offer as much assistance as possible. WE REQUIRE ALL NEW PATIENTS TO CALL OUR OFFICE TO SPEAK WITH SOMEONE IN OUR BILLING DEPARTMENT AT LEAST 3 DAYS PRIOR TO THE SCHEDULED APPOINTMENT. You may reach our billing department by dialing 304-346-4400 extension 115.

We have decided not to participate with a few managed care plans including Carelink and Aetna.

Each person covered under a group health plan should receive a member ID card. However, possession of an ID card does not guarantee coverage or payment of services rendered. Patients will be required to present this card at each visit to assure that coverage and benefits have not changed since their past visit. This will aid our staff in verifying eligibility and benefits and filing claims on your behalf.

It is to your benefit to know and understand your insurance coverage. Failure to do so could result in your financial loss through reduced benefits or denied payments of your claims. You can obtain coverage and benefit information, prior to your visit, by calling the toll-free number on your ID card or by contacting the benefits department of the employer providing the coverage. We can help you receive maximum reimbursement from your insurance company if you can provide us with current and accurate information.

Thanks in advance for your cooperation and assistance.


Rick Wilton
Practice Administrator

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