Common Health Insurance FAQ

What charges am I responsible for if I have insurance?

If you have health insurance from one of the insurance companies that ACT is contracted with, you will be responsible for your co-pay, any deductible that your policy has, and for any charges that are not covered by your insurance policy. The exact charges that are not covered will be determined by your insurance company.

What is co-insurance?

Co-insurance is the amount of money that your health plan requires you to pay for services after your deductible has been met. Co-insurance is often a percentage. For example, you may be required to pay 20 percent of the charges and your insurance company will pay 80 percent.

What is a deductible?

A deductible is the amount you must pay for health care expenses before insurance even starts to cover the cost of your care.

Is a deductible the same as a co-payment?

A deductible is not the same thing as a co-payment.  A co-payment (co-pay) is the pre-determined amount that your insurance policy requires you to personally pay for services on the day of visit.  For example, it may be $40 for the visit and then your insurance will cover the rest of the charges for the day.

Why didn’t my insurance pay for services I received?

You should receive an Explanation of Benefits letter from your insurance company that explains why they did not pay for certain services. Three of the most common reasons that your insurance does not pay for services are

• You have not met your deductible
• Services you received are not covered by your policy
• An error could have been made in filing your insurance

Always check with your insurance company if you have questions about the services they did or did not cover. Let us know what you find out and we will work with you to re-file claims.  We want you to get the maximum benefits due to you.

Office Statements and Bills FAQ

We’ll make things easier for you by billing your insurance company and keeping you up to date on your account and charges.

If your insurance requires a co-payment or deductible, you are responsible for these charges on the day of your appointment.  If your insurance does not cover certain charges or if there is an unpaid balance of any type, you are responsible for paying for those services within 30 days of receipt of a statement from us.

After we hear back from your insurance, we will send a statement to you.  Payment is expected within 30 days.

Why did I receive a separate bill from the lab, hospital, and from Dr. Hipke?

Many times services that are provided by a hospital or lab that also have physician charges associated with the services. In those instances you may get a bill from both the hospital as well as a bill from Dr. Hipke for services he provided as part of your care. Many laboratory services for our patients are contracted, but sometimes certain tests are sent to another laboratory for processing. This may result in the patient receiving a bill for the services provided by other facilities.

What are 'non-covered services' and why must I pay them?

In many situations, non-covered services are services that may be important to your health, but are services that your insurance does not pay for based on your policy. In other instances, they may be services that are considered experimental or cosmetic in nature and are not paid for by your policy. Check with your insurance company to find out what services are not covered by your policy.

Where can I get an itemized bill?

You can click Contact Us and send a message to request an itemized bill.

Why does my statement have a balance forward amount?

After you receive services from Dr. Hipke, you will receive a statement if you did not pay your bill in full on the day of the visit.  If the services are not paid in full within 30 days, your next statement will show a balance forward amount.

How can I make a payment?

• By Cash, check or money order (make payable to “Dr. Matt Hipke” or ”Adolescent Care Team”)
  
  
• By Credit card (Visa, Mastercard, Discover)  You will need the zip code of the billing address for the card.  Card numbers are not retained at The Adolescent Care Team.
  
  
• By Phone: Call the office at CLOSED to talk with us.
  
  
• You can pay your bill in person at The Adolescent Care Team.
  
  
• By Mailing payments to:
       The Adolescent Care Team
       911 Walnut Hill Dr.
       Longview, TX 75605-5054

Who is responsible for paying my bill?

As a patient or legal guardian, you are ultimately responsible for all services you receive from Dr. Hipke.  For patients who are minors, the guarantor (the person who is legally responsible for the minor) will be responsible for the bill. ACT will be happy to file your insurance for you with your insurance company. ACT will also work with each insurance company to help you receive maximum reimbursement on services provided.   However, payment for services is still each patient’s responsibility.

How do I know if Dr. Hipke received my payment?

ACT will not send you a statement if your account has been paid in full. Your cancelled check or the charge on your credit card bill will serve as your receipt for the payment. If you believe that a payment was not applied to your account, call us at CLOSED or send us a message.

Does Dr. Hipke use a collection service?

ACT does not use a collection service.  Happily, we have not needed one for 17 years.

Most Important Health Insurance FAQ

How can we help you make all this a bit easier?

Please communicate with us.  Dr. Hipke never wants money to come first.  Your teen's health is much more important.  We will work with you about the money.  'Just not showing up because I might owe a bill' is not a reason to skip an appointment.  You will be pleasantly suprised by the willingness of Dr. Hipke to help your teen / tween.

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