All medical insurances and plans are accepted. Please remember that co-payments and deductibles may apply, and these will depend on your specific insurance plan and the policy that you have purchased.

If you have medical/dental insurance, the office staff is able to help you receive your maximum allowable benefits. In order to achieve these goals, we need your assistance and understanding of our payment policy as well as your own insurance policy.

As a courtesy, our staff will file a claim form to your insurance company, but you are financially responsible for the services rendered regardless of your insurance. Payment for services are due at the time services are rendered unless payment arrangements have been approved in advance by our staff. We accept cash, checks, most major credit cards and a payment plan with Care Credit, which allows you to make a flexible, low monthly payment, and has interest free options. Upon credit approval for the payment plan, you can charge your treatment immediately.

The staff will gladly discuss your proposed treatment and answer any questions relating to your insurance. You must realize however that:

1. Your insurance is a contract between you, your employer and the insurance company. Dr. Benjamin J. Cousins MD is not involved or included in that contract. Your contract is with the physician, not between the insurance company and the physician.

2. Not all services are covered benefits in all insurance contracts. Some insurance companies arbitrarily select certain services they will not cover.

3. Please review your insurance contract carefully. Insurance companies will not cover, will not pay for and will decline acceptance for bills for certain procedures, visits and medical tests often resulting in much higher out of pocket costs to you and/or the patients.

4. It is emphasized that as medical care providers, the relationship is with you, not your insurance company. While the filing of insurance claims is a courtesy that we extend to our patients, all charges are your responsibility from the date the services are rendered. The staff and I realize that temporary financial problems may affect timely payment of your account. If such problems do arise, we encourage you to contact the office promptly for the assistance in the management of your account.

THE FOLLOWING FINANCIAL ARRANGEMENTS ARE AVAILABLE TO YOU:

[ ] OPTION A: Payment in full at time of service.

1. Payment is expected at the time of treatment in the form of cash, check, or credit card.

[ ] OPTION B: Coverage by medical or dental insurance.

1. The fee for the consultation and/or procedure is due in full at the time of your appointment.

2. If you want to know in advance how much of your fee the insurance will cover, we will be happy to submit a pre-estimate request to your insurance company. Once the insurance company answers as to what portion of your treatment they will cover and for how much, you will then know approximately how much money you can expect from your insurance company, minus any deductible which may apply. You will still have to pay our office for your services in full, but we will submit the insurance paperwork on your behalf and ask the insurance company to send the check directly to you.

[ ] OPTION C: Financing treatment fees or balances.

1. Patients wishing to finance fees may be eligible for commercial financing. Please request details from our staff.