Federal Tax ID Number : 75-2656096
NPI : 1033113469
Legacy Medicare/Blue Cross Number : 00K61G
Legacy UPIN Number : B23158
Medicaid Number : P000K61G8
Insurance Coverage
I will not be able to answer specific questions about your insurance coverage. If you have questions about your insurance coverage, please consult your handbook or your company's human resources department.
Insurance claims are automatically filed by my office for patients with contracted insurance companies. All others will be provided itemized statements that can be used for insurance filing or tax returns, or insurance claims will be filed for you upon request. If your insurance company has not paid their portion within 60 days from the date of service, you are responsible for payment at that time and your insurance company may reimburse you for their portion.
Patients with insurance other than contracted insurance companies who request my office to file claims on their behalf are required to either:
1. Pay all charges in full at the time of service
or
2. Have a credit or debit card on file for payment of charges not covered by insurance.
Medicare and contracted insurance companies patients are requested to pay applicable co-payments and deductibles at the time of service.
Medicare patients with Medicare Supplement policies (Medigap coverage) are requested to pay applicable co-payments and deductibles until their secondary insurance has been established. These can be paid at the time of service, or with a credit card on file.
Medicare patients with Medicaid QMB are only responsible for charges not covered by Medicare, they are not required to make any co-payments.
If you would like my office to file insurance claims on your behalf, kindly complete the debit authorization form and return it to me. Charges will be made to your credit or debit card after the final insurance payments have been received and applied. Of course, you may also elect to pay my fees directly and file your own insurance claims, I will be happy to provide an itemized statement suitable for your use with an insurance claim.
If you have any questions or concerns, please bring it up with me, or speak with my assistant, Keri.
The responsible party remains liable for all charges, whether or not they are covered by insurance. Please be sure you fully understand your insurance benefits and Dr. Grugle´s financial policies before arriving for your first appointment. If your insurance company has not paid their portion within 60 days from the date of service, your credit card will be charged.
Finance charges of 10% per annum will be assessed on any balance over 60 days past due.
Full payment is required at the time of each visit unless prior arrangements are made. HMO, PPO or Medicare patients are required to make full payment of all copayments and deductibles at the time of service.
Patients or responsible parties are liable for all fees regardless of insurance coverage. Monthly payment on all accounts is required.
Payment may be made by cash, check, Discover, American Express, ATM Card, MasterCard or VISA.
Payment can also be made online at paypal.com. Send the payment to tgrugle@mac.com.
There is a $25 fee on all returned checks. Statements are mailed monthly and are due upon receipt. A finance charge of 10% per year will be assessed monthly to any overdue balance. A delinquency fee will be assessed on accounts which require additional collection action. Every effort will be made to inform you of all charges in advance. If you have any questions about the fees or any other financial concerns please discuss them with Dr. Grugle.