ADVANCE COST ESTIMATE NOTICE FOR SELF PAY PATIENTS OR PATIENTS THAT HAVE INSURANCE THAT BENSON HEALTH CLINIC IS AN OUT OF NETWORK PROVIDER, SUCH AS CIGNA AND HEALTHNET.
If you are an uninsured or a self-pay patient, you have the right to a good faith estimate of expected charges prior to receiving services if your appointment is scheduled three (3) or more days from the date of the request. If you have Out of Network Benefits and we are an Out of Network provider with your insurance plan you have the option to pay self-pay rates. This estimate does not include tests ordered the day of your appointment.
Due to the nature of our clinic, you will have routine visits with your provider. Length of time and diagnosis are what creates the codes that are used to bill the insurance. We will give you one good faith estimate that will be good for 12 months. If you end up seeing another provider in our clinic, we will then give you another good faith estimate for that provider.
If your appointment is scheduled three to nine (3 to 9) days from the date of a request for an appointment with us, Benson Health Clinic will provide a written good faith estimate of expected charges prior to the services. You should expect to receive a letter sent via first class mail or via email if at your request. You may also receive a phone call from us with the advance cost estimate prior to your services. If your appointment is scheduled nine (9) or more days after the request for an appointment with us, you should expect to receive a letter sent via first class mail or a printable estimate via email if at your request. Please update your address and verify with us that we have your most up-to-date current address.
If at any time you get a new Insurance that you would like to be billed, then you will need to inform us immediately, some insurances require an authorization prior to being seen, for those insurances you will still be responsible for those visits even though you had insurance coverage.
Benson Health Clinic is currently participating in the following insurance plans.
Please note that not all providers are accepting all of these plans.
Benson Health Clinic is not a participating provider with the following insurance plans Trillium, HealthNet, and CIGNA.