Financial Policy

Thank you for choosing Sleep Centers of Middle Tennessee, PLLC (“SCMT”). We are committed to continually improving the field of sleep medicine in quality, cost and convenience of care. We require that you read the following statement of our financial policy prior to any treatment.

Payment expectations

Payment requirements and due dates

  • For insured patients, copay will be collected when services are rendered for in-office or telemedicine appointments with a clinician, RT or provider. Any remaining balance after copay will be billed to your insurance. If they identify additional patient responsibility, that balance will be billed to you and is due within 30 days.
  • For self-pay patients, a minimum of $50 deposit will be collected at the time of your visit for in-office or telemedicine appointments with a clinician, RT or provider. The balance will be billed following your appointment and is due within 30 days.
  • Payment of your out-of-pocket cost is due prior to obtaining an in-lab sleep study or home sleep study. Sleep studies cannot be provided without prior payment arrangements.

Payment options

How payment fees are determined

Fees for insured patients:

After providing your medical services, we will file a claim with your insurance company. If additional monies are owed to SCMT, we will bill you for the balance.

If your insurance company determines you may have overpaid, and provided you have no additional pending or expected services for us to apply the overpayment to, we will issue you a refund.

We will estimate your out-of-pocket cost for your sleep testing (if testing is ordered by a care provider). An estimate is the predicted amount your medical services will cost you. This is based on our total charge for the service, as well as what your personal out of pocket costs could be based on your insurance benefits. These fees include, but are not limited to, copayment, co-insurance or deductibles, and any care costs identified as your responsibility by your insurance company.

Please note your final charges and cost may differ from our original estimate based on the services received and your use of your insurance benefits outside SCMT.

Fees for uninsured or self-pay patients:

For patients without insurance or if you prefer not to file a claim on your insurance, we will bill you at our standard self-pay rates.

Hardship plan if you are unable to pay before or time of service

In limited circumstances, if you are unable to pay your bill at the time of service or prior to a sleep study, we may allow an in-house payment plan (also called a Hardship Plan). To qualify for a Hardship Plan, you must first apply to Care Credit. In the event your application is denied, we may extend an in-house payment plan which meets minimum down payment and automatic monthly payment requirements.

Standard terms

  • Proof of payment and photo ID are required for all patients. We will ask to make a copy of your ID and insurance card for our records. Providing a copy of your insurance card does not confirm that your coverage is effective or that the services rendered will be covered by your insurance company. You will be required to show your insurance card at each visit.
  • We will attempt to confirm your insurance coverage prior to your treatment. It is your responsibility to provide current and accurate insurance information, including any updates or changes in coverage. Should you fail to provide this information, you will be financially responsible.
  • If we do not contract with your insurance company, you will be expected to pay for all services rendered at the end of your visit. We will provide you with a statement that you can submit to your insurance company for reimbursement.
  • It is your responsibility to know your own insurance benefits, including whether we are a contracted provider with your insurance company, your covered benefits and any exclusions in your insurance policy, and any pre-authorization requirements of your insurance company.
  • Please understand some insurance coverages have Out-of-Network benefits that have co-insurance charges, higher co-payments and limited annual benefits. If you receive services are part of an Out-of-Network benefit, your portion of financial responsibility may be higher than the InNetwork rate.
  • If your insurance plan or policy changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.
  • Balances over 90 days old will be referred to collections.

Other fees

  • Advance notification of at least one business day is required to cancel or reschedule an office or telemedicine appointment. Missing an office or telemedicine appointment without appropriate notification may result in a $25.00 fee.
  • A $30.00 fee will be charged for a returned (bounced) check. This is to cover the fees charged by our bank for a returned check. If our bank increases its fee, we reserve the right to increase this charge without prior notice.
  • No show fees will apply for in-lab sleep studies. If you cannot attend your in-lab sleep study, you must call our office at least 24 hours in advance to reschedule. Missed appointments without notification may result in a $100.00 fee.

Insurance

As a service, we will complete and submit insurance forms to your insurance carrier. You will need to present your insurance card at your first visit and may need to verify this information at subsequent office visits.   If there are any changes in your insurance and/or personal information (i.e. name, address, phone number), please notify our office so we can maintain accuracy in our billing.   We are service providers for the following plans:

  • Aetna
  • Blue Cross/Blue Shield
  • CIGNA
  • Mailhandlers
  • Medicare
  • PHCS
  • Tricare
  • United Healthcare
  • and others…

Please contact us with questions about your insurance coverage.

We are happy that you have chosen Sleep Centers of Middle Tennessee to provide your health care needs. We are committed to providing the best care and service available. As part of this commitment, it is important that you have a clear understanding of our financial policies. Our staff will be glad to answer any questions you may have. If you have any questions or require further information about our financial policies or billing policies, please contact us at (615) 921-2400.