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CREDIT POLICY

CARDIOLOGY ASSOCIATES OF SAVANNAH, L.L.C.

In the interest of good medical practice, we have established the following credit policy. We hope that this written policy will help avoid misunderstandings about payment of bills.

Deductible and/or co-pay(s) are expected at the time of your visit. We accept cash, check, or Visa/MasterCard as payment for all services. We will accept payment of larger bills over an extended period of time if necessary, and if arrangements are made in advance. In such cases, a down payment of 20% will be required, and a "PAYMENT PLAN" must be set up. Marina, in our Collections Department will be glad to assist you with this. Marina can be reached at (912) 961-8620 or call her on our toll free number 1-888-472-5722. Ask for Marina.

We are participating providers for Medicare, Medicaid, Tricare, Blue Shield, Blue Choice and various PPOs and HMOs.

Insurance information, with appropriate identification numbers must be furnished at the time of the initial visit and on each visit thereafter. We process insurance claims for hospital-related and office charges, however, the patient is always responsible for payment over and above insurance payments.

If your insurance requires a patient co-pay, you are responsible for the amount designated on your card. Please bring this amount with you at the time of each visit. If you are a Medicaid patient, please check your card. If "yes " is printed in the co-pay column, you will be responsible for the $3.00 co-pay. Please bring this amount with you at the time of your visit.

If your insurance requires a referral form and/or referral number from your primary care physician, please check with your primary care physician to be sure that the paperwork is being, processed and the form and/or number will be available to Cardiology Associates of Savannah, L.L.C. at the time of your visit to this office. If you arrive without this information your appointment will likely be held up and possibly rescheduled.

Assignment of benefits will be required whenever a balance is not paid in full. Monthly statements are due fifteen (15) days after mailing.

Accounts that are three (3) months past due are considered delinquent and will be turned over to a professional collection agency.