Financial Policies

Please download and fill out the forms below and bring to your first appointment:

New Patient Information Form (1 page)
AMC Billing Policy (1 page)






Financial Details



• As a courtesy to you, our patient, we will be happy to accept assignment of benefits for most insurance companies. However, it must be understood that the contract is between the patient and the insurance company. The patient is fully responsible for any amount not paid by the insurance carrier. Our office policy regarding insurance claims is as follows:

• It is the patient’s responsibility to provide our office with complete insurance or billing information at the time of service, or the fees must be paid in full. Alaska Medicaid recipients are required to present proof of coverage each month.

• The patient is required to pay their portion at the time of service. This includes co-pay amounts, deductibles, or noncovered services.

• Our office cannot guarantee the amount that an insurance company will pay. Any unpaid balances after 90 days from the date of service will be the patient’s responsibility to pay. It is the patient’s responsibility to be familiar with the insurance coverage.

• Our office will not go into a dispute with any insurance company over a claim. This is the patient’s responsibility and obligation. We will provide any information requested by the insurance company.

• A charge of $30.00 will be assessed for any returned checks. The patient/guarantor will be held responsible for any collection charges incurred on a delinquent account.

 

Our clinics accept numerous insurances, most major credit cards, and checks. We look forward to providing you with the best medical care!

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