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Stephen A. Benson, D.P.M.
Scheduling Appointments
What to Bring to Your Appointment
Patient Forms
Privacy Practices
Insurance and Payment Information
Hospital Affiliations
Scheduling Appointments
We realize that our patients' time is valuable, and we make every effort to see patients at their scheduled appointment time. We ask that patients provide as much advance notice as possible when running late for an appointment or when cancelling. With this advance notice of cancellation, the time can be scheduled for another patient.
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What to Bring to Your Appointment
If you are a first-time patient, please plan on arriving early to complete a patient registration form. Please bring the following items to the appointment:
- Insurance card(s)
- Referral forms (if required)
- List of all prescription and over-the-counter medications that you are currently taking
- Any required co-payment
- Pertinent medical and surgical history information
- X-ray films that you may have
- Completed patient forms
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Patient Forms
We are pleased to provide our patients with the following form. Please view, print, and complete this form before your office visit.
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Privacy Practices
Notice of Privacy Practices for Stephen A. Benson, D.P.M. (PDF) [PDF help]
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. Please complete the Acknowledgement of Receipt Form.
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Insurance and Payment Information
We are dedicated to providing the best possible care and service to you. We regard your complete understanding of our financial policies as an essential element of your care and treatment. If you have any questions, please discuss them with our front office staff or supervisor.
- Please click here for a list of insurance plans accepted by Dr. Benson
- As our patient, you are responsible for all authorizations/referrals needed to seek treatment in this office.
- Unless other arrangements have been made in advance by you or your health insurance carrier, payment for office services are due at the time of service. We will accept cash or check.
- Your insurance policy is a contract between you and your insurance company. As a courtesy, we will file your insurance claim for you if you assign the benefits to the physician. In other words, you agree to have your insurance company pay the doctor directly. If your insurance company does not pay the practice within a reasonable period, we will have to look to you for payment.
- We have made prior arrangements with insurers and other health plans to accept an assignment of benefits. We will bill those plans with which we have an agreement and will only require you to pay the co-pay/co-insurance/deductible at the time of service.
- If you have insurance coverage with a plan with which we do not have a prior agreement, we will prepare and send the claim for you on an unassigned basis. This means your insurer will send the payment directly to you. Therefore, all charges for your care and treatment are due at the time of service.
- All health plans are not the same and do not cover the same services. In the event your health plan determines a service "not a covered benefit" or you do not have an authorization, you will be responsible for the complete charge. We will attempt to verify benefits for some specialized services; however, you remain responsible for charges to any service rendered. Patients are encouraged to contact their plans for clarification of benefits prior to services rendered.
- You must inform the office of all insurance changes and authorization referral requirements. In the event the office is not informed, you will be responsible for any charges denied.
- For most services provided in the hospital, we will bill your health plan. Any balance due is your responsibility.
- Past due accounts are subject to collection proceedings. All fees including, but not limited to collection fees, attorney fees and court fees shall become your responsibility in addition to the balance due this office.
- There is a service fee of $25.00 for all returned checks. Your insurance company does not cover this fee.
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Hospital Affiliations
Dr. Benson is affiliated with the following medical facilities.
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