Buffalo Medical Group patients are ultimately responsible for the payment of their medical bills. Our Central Business Office staff will be glad to work with you regarding your medical bill.
Some insurance companies pay the total amount of the bill, while others pay less. Some insurance companies also require deductibles or pay percentages. You are responsible for the deductible, payment of the bill, or the balance of the bill after the insurance company has made payment.
If your insurance requires a co-payment, the co-payment is due at the time of your visit. If your insurance requires pre-authorization for certain procedures or hospital admissions, you should inform your physician’s office. This will enable you to secure the necessary pre-authorization and avoid possible delays in receiving the care you require.
A health maintenance organization is a corporation that combines health care financing and
health care delivery in a single organization for enrollees or subscribers within a geographical
area, and uses a specific group of providers. In Western New York, the main HMOs are
Independent Health, Community Blue, and Univera Healthcare. The BMG will submit claims
to HMOs on your behalf.
Some insurance companies require referrals when patients seek care from a doctor other
than their primary care physician. All patients are responsible for obtaining referrals. If a
referral is not available at the time of service, the patient will be required to sign a waiver
before services are rendered. However, we encourage you to contact your primary care
physician’s office before the appointment to obtain a referral so that you will not be
responsible for paying the entire bill. Please call for referrals during regular business hours.
When you call, it will be important to have the date of the visit, the correct spelling of the
specialist’s first and last names, and the reason you are seeing the doctor. This will help to
ensure accuracy when your primary care physician’s office creates your referral. It is
important for you to know that it is the policy of the Primary Care Division not to back date referrals.
The Buffalo Medical Group requires payment at the time of service. If the BMG participates in your health plan,
applicable co-payments will be collected at the time of registration.
Our Central Business Office will submit insurance claims to Blue Cross or Blue Shield for you.
Payment will be made directly to your doctor if he/she participates in Blue Cross or Blue
Shield. You are responsible for paying for any services not covered under your contract. Even
though an insurance claim has been submitted, you may receive a monthly statement from the
Buffalo Medical Group if your doctor does not participate with that insurance company. If
this is the case, you are responsible to pay your bill. Reimbursement will be sent directly to
you from the insurer.
In most cases if you have commercial insurance, BMG Central Business
Office will submit the initial claim to your insurance
company. Ultimately, the insurance company may send its payment directly to you. If this
occurs, the payment should be forwarded to the Buffalo Medical Group. The amount of the
payment you receive is based on the terms of the contract you have with the insurance carrier.
The Buffalo Medical Group cannot accept responsibility for negotiating a settlement with your
insurance company for a disputed claim, or for collecting your payment from the insurance
company. If you have any questions about such matters, a member of our Central Business
Office will be available to talk with you. Please call 630-2600.
The fees charged for tests and procedures performed by the Buffalo Medical Group are
considered to be fair and reasonable.
Some insurance companies may have reimbursement rates (the payment rates received by the
Buffalo Medical Group for services) lower than our fees. However, you are still responsible
for the payment of the entire bill.
If you have a problem paying a bill, or fall behind with payments, please call our Credit
Department immediately at 630-2650, so we may assist you in resolving the matter.
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