Fruita (970) 858-9894 Redlands/Grand Junction (970) 243-1707

Insurance

Western Valley Family Practice will help in any way we can with your insurance requirements, physician referrals, and payment for services.

All of our physicians participate with MEDICARE, MEDICAID, and many private insurance plans.

We will bill your insurance company on your behalf and make every effort to resolve any billing problems that arise. Our reception staff will be happy to provide you with more information when you call for an appointment.

We do accept Workers Compensation and MOST Motor Vehicle Claims. Please call our office and ask for our Workers Comp/Motor Vehicle Specialist for more information.

There are also many insurance plans that we do not contract with. That maybe because of unacceptable contract provisions, insufficient “covered lives” in our service area, or it may be an “open plan” that does not contract for services. As a courtesy to our patients, we still bill these insurance carriers on your behalf. However, we expect payment at time of service.

Co-Pays, Co-Insurance, and Deductibles.

Many insurance plans require that we collect co-pays and/or deductibles from the patient at the time of service. By law we cannot waive these fees. MEDICARE has enacted tough penalties for providers who do not make a diligent effort to collect these payments from the patient. If you don’t pay your co-pay, co-insurance, or deductible at the time of service we will assess a $10 fee to your account.

Medical Discount Cards

WVFP does not participate with any of the “Medical Discount Card” plans. Patients of any of these plans are responsible for payment at time of service.

Referrals and Preauthorization’s

Many private insurance plans require referrals and/or preauthorization’s for certain types of services. Because of the multitude and complexity of plans, our office may not be aware of the requirements of your particular health plan. We strongly advise that you read your plan materials or consult with the plan’s customer service department to determine if there are any special requirements. If you do not get the necessary referrals or preauthorization, the insurance company will often refuse to pay the bill and you will be responsible for payment of any services done. Please check with your insurance before any service are done to see if a preauthorization is needed. We will be glad to assist you in obtaining these items and answering any questions that we can.

EOB’S and Statements

In most cases you will receive an EOB (Explanation of Benefits) from your insurance carrier outlining what was billed on your behalf and what was paid. The EOB should also provide an explanation of any amounts that you owe. There are many different formats and codes used by the various insurance companies. If you have questions regarding the information contained on your EOB, it is usually best to call the member services department at the insurance company. If you have questions about the services shown on the EOB, please call our billing department.

No Shows

You will be billed a no show fee of $20 for a regular appointment and $40 for a Physical, Well Child Check, or Diabetes Visit if you do not call at least 24 hours prior to the appointment and cancel. New patients that do not show up for their new patient appointment will not be rescheduled.

If you would like and itemized statement for your records we will be happy to provide you one on request.


Connect For Health Colorado

Connect for Health Colorado is a marketplace that opened in October 2013 to help individuals, families and small employers across Colorado purchase health insurance and apply for new federal financial assistance to reduce costs. 

1-855-752-6749

http://connectforhealthco.com/