Insurance

We want to take a moment of your time to inform you of our policies regarding payment. Payment in full is expected when services are rendered unless other specific arrangements are made in advance. For your convenience, we accept cash, local personal check, MasterCard, Visa, Discover and American Express.

The physicians and physicians assistants at Aspen Medical Care participate with the following insurances and/or networks:

Aspen Skiing Company
Aspen Valley Hospital
BCBS PPO and HMO (Please check with your insurance, employer, or broker as network limitations may exist.)
CIGNA PPO (Please check with your insurance, employer, or broker as network limitations may exist.)
Cofinity/Aetna PPO
Great West PPO
Medicare
Roaring Fork Valley Community Health Plan
Rocky Mountain Health Plans PPO and HMO (but not CHP+ or Medicaid)
The Colorado Network PPO
UnitedHealthcare PPO
Valley View Hospital

This list is current as of October 1, 2015 but is subject to change without notice.

If you have insurance with which we participate, we will submit your insurance claims for you. You will need to provide to us, at the time of service, a valid insurance card, address for submitting claims and a telephone number allowing us to verify coverage. You are responsible for your copay at the time of service and for any amounts not covered by your insurance, including deductibles and coinsurance. Failure to pay your copay at the time of service may result in an additional $15 fee. If you have any special requests or instructions regarding billing for services provided, we must be informed before services are rendered. it is your responsibility to verify with your insurance that you are seeking services from an in-network physician. We will provide information on our participation status based upon the best information available to us at the time, but if coverage is denied for any reason, you are responsible for payment of the entire balance.

NON-PARTICIPATING INSURANCE: If we do not have a contract with your insurance, we expect payment at the time of service. For your convenience, we accept cash, local personal checks, MasterCard and Visa, American Express and Discover. We will provide you with the information you’ll need to file with your insurance for reimbursement. It is your responsibility to contact your insurance in the event of nonpayment or discounted payments. Many private insurance companies, in an effort to discount physician fees, restrict payment indicating that fees are over their “Usual and Customary” fees for this area. We have ensured that our fees are comparable to that of other offices providing the same quality and level of care. We will not allow insurance companies to set our fees for us.

WORKERS’ COMPENSATION INSURANCE: If your visit involves an accident or work-related injury, we must know the name and address of your employer, the accident date, where it occurred, the nature of the accident, and the telephone number of the adjuster for your case. Workers’ Compensation laws require the employee to report injuries to their employer. We cannot bill your regular health insurance for work-related injuries. If this information is not provided, or payment is denied for any reason, you are responsible for payment of the entire balance.

AUTO INSURANCE: If you were involved in an auto accident, we will expect payment at the time of service. For your convenience, we accept cash, local personal checks, MasterCard and Visa, American Express and Discover. We will provide you with the information you’ll need to file with your auto insurance for reimbursement.

PRIVATE PAY: If you do not have insurance, we expect you to pay for your visit at the time of service. For your convenience, we accept cash, local personal checks, MasterCard and Visa, American Express and Discover.

NON-PAYMENT: In the event your account is not paid within 30 days of treatment or according to an agreed upon payment plan, interest will be assessed at the rate of 18% per annum on the unpaid balance. If your account becomes delinquent, it may be forwarded to an outside collection agency without notice. If this happens, you will be responsible for all costs of collection, including but not limited to interest, rebilling fees, court costs, attorney fees and collection agency costs. Insurance benefits are a matter between you and your insurance company. You are ultimately responsible for payment on your account.

RETURNED CHECKS: Returned checks are subject to a $25 service charge.

If you have any questions regarding our payment policies, please ask us before your visit.

Aspen Medical Care’s Financial Policy Download

INSURANCE TERMS DEFINED:
Coinsurance: Coinsurance is a set percentage you pay toward the total cost of your medical care. If you were admitted at the hospital, had lab tests done or needed outpatient surgery, you will probably need to pay coinsurance. Some plans may offer you the option of paying coinsurance for a doctor visit instead of a copayment.

Copayment: A copayment is a set fee you pay for doctor visits, prescriptions and hospital services. You pay this amount at the time you receive medical care. Copayments can range from a few dollars to a few hundred dollars depending on the services you need.

Deductible: This is the set dollar amount you are required to pay for medical services before your insurance starts to pay. Like copayments, deductibles are applicable to doctor visits, prescription and hospital services. You may have to pay a separate deductible for each covered family member.

Maximum Benefit: This is the maximum amount your insurance company will pay for a certain type of service. This usually applies to preventive services. Any covered amount in excess of the maximum benefit will be your responsibility.

Maximum Out-of-pocket Limit: This is the maximum amount you have to pay for your medical care expenses. Any deductibles and coinsurance paid counts toward this amount. There may be a separate maximum out of pocket cost for each family member.

Uniform Glossary of Terms (from The Center for Consumer Information and Insurance Oversight)

Thanks to the Affordable Care Act, the jargon that makes it impossible to figure out what is covered and how one insurance plan stacks up compared to another will be replaced with terms that are the same across all plans. Insurance companies and group health plans will be required to make available upon request a uniform glossary of terms commonly used in health insurance coverage such as “deductible” and “co-payment”. To help ensure the document is easily accessible for consumers, the Departments of Health and Human Services (HHS) and Labor will also post the glossary on the new health care reform website, www.HealthCare.gov and www.dol.gov/ebsa/healthreform. (You may access the glossaries directly at http://www.dol.gov/ebsa/pdf/SBCUniformGlossary.pdf and at http://www.healthcare.gov/glossary/a/.)