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At Guardian Health, we are committed to providing quality, accessible, and affordable care to our patients. We offer a range of payment options, including cash payments, health savings plans, and a variety of insurance plans.
While we are still actively in the credentialing in the credentialing process, please be sure to ask our clinic team if your insurance is in network prior to your visit. We are actively working towards credentialing to make your care more affordable and convenient. We do accept & bill out-of-network insurance. However, since we may not have contracts with these insurers, we cannot attest to coverage. Regardless of whether we are in-network or out-of-network we will bill your insurance upon your request. It is important to note that if the patient has insurance then their agreement is between them & their insurance company which is a separate organization from your healthcare Provider. We are actively negotiating contracts with the following insurers. Please contact us for the latest updates in our in-network status with your insurer:
We are happy to work with health sharing plans; however, please note that health sharing plans are not subject to the same regulations as traditional insurance. If your health sharing plan does not cover your bill, you will be responsible for the remaining balance.
In compliance with dual fee laws, we must charge usual, customary, and reasonable (UCR) rates for your geographic area, similar to the rates we charge insurance companies under our contracts. We reference the CMS Physician Fee Schedule, which you can review here, in conjunction with our negotiated insurance contracts to calculate these charges.
For out-of-network insurance patients, please note that we may bill your insurance but cannot guarantee coverage and patients will be responsible for all services which are not covered by their policy. Balance billing, where patients are charged the difference between what we bill and what the insurance pays, is NOT practiced at our clinic.
We adhere to the No Surprises Act, which allows patients to request a transparent cost estimate for services prior to their visit. Please note that this may extend your visit time, and in some cases, we may need additional time to provide a detailed cost estimate.
For cash payment estimates, we recommend referring to the CMS Physician Fee Schedule. Additionally, under the Budget Reconciliation Act, if you are seen by a nurse practitioner, your charges will be 85% of the standard rate.
At Guardian Health, we believe in providing fair, accessible, and affordable care. You have the right to choose your healthcare provider under the Affordable Care Act, and if you are receiving care from a nurse practitioner, you can request to be referred to a physician under the Missouri Nursing Practice Act and the Collaborative Practice Agreement Statute.
We strongly advocate for the protection of your private health and financial data. Our clinic is strictly HIPAA compliant, ensuring that all patient information is kept confidential and secure.
We also adhere to state price transparency laws, ensuring that patients are fully informed about the cost of their care. Additionally, we comply with local, state, and federal regulations when referring patients for specialized services.
We strictly adhere to the Sunshine Act (42 U.S.C. § 1320a-7h), which requires transparency regarding any financial relationships between healthcare providers and medical manufacturers. This law ensures that providers remain unbiased when making care recommendations.
In compliance with Federal Trade Commission (FTC) regulations, we follow strict debt collection guidelines that protect patients from unfair or deceptive practices. The False Claims Act (31 U.S.C. §§ 3729–3733) also plays a key role in our operations, ensuring that billing and claims submitted to insurance companies are truthful and accurate. This law holds healthcare providers accountable for any false or fraudulent claims submitted for reimbursement, protecting both the government and patients from financial misconduct.
At Guardian Health, we are committed to upholding Christian values in all of our billing practices. We will continue to stay up-to-date on all relevant healthcare regulations and statutes to ensure our practices are in full compliance with federal and state laws. We believe in providing compassionate, honest, and transparent care to every patient who walks through our doors.
Citations for Reference:
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