Thank you for your interest in DeKalb Clinic. The business office staff is committed to providing you with the most friendly and caring service possible. We strive to handle every concern in an efficient and personal manner. We hope these pages will provide you needed information about the operations of DeKalb Clinic.
We hope your experience with DeKalb Clinic is the beginning of a satisfying relationship for you and your family. If, however, you have questions concerning your account, please contact our Patient Account Department at (815) 758-8671, ext. 3640. All policies are subject to change without prior notification.
We will be happy to file your insurance automatically. This eliminates excessive paperwork for you and usually increases response time from your insurance carrier. We strive to process each claim accurately and efficiently.
DeKalb Clinic participates as a preferred provider in many networks. However, participation requirements and eligibility frequently change. It is best not to rely on printed network directories. When selecting a new physician, please contact your health plan administrator or provider network website to verify participation by your DeKalb Clinic physician.
Patients with a Managed Care Plan may be required to obtain a referral from their Primary Care Physician if they need to see a specialist. While we will be glad to assist you to obtain the file needed for paperwork, it is the patient's responsibility to obtain this authorization PRIOR to being seen by the specialist. Failure to do so may result in reduction of benefits or denial of payment by your insurance carrier. Patients whose plans have a co-payment will be required to pay the designated amount at the time of service.
The doctors of DeKalb Clinic are participating providers who accept assignment with Medicare. This means that Medicare determines the amount we can receive for a service. Medicare also determines what charges will not be allowed (such as preventative services, certain injections, and various types of screenings.) Of the allowed amount, Medicare pays 80% and the patient is responsible for 20% as well as an annual deductible. Our office will file all your Medicare claims for you. After receiving payment, we will send you a statement showing the amounts you are responsible for paying, including the co-insurance, annual deductible and any non-covered services.
Many Medicare patients have supplemental insurance to cover the co-insurance. After we receive payment from Medicare, we will also file your supplemental claim. If your supplement carrier sends a check to our office, you will receive a statement from the carrier telling you payment has been made. If payment is received by us it will reflect on your monthly billing.
We ask that Medicaid patients bring proof of their coverage at each visit. Medicaid patients may be required to obtain a referral from their Primary Care Physician before scheduling an appointment with a specialist. Any services denied by Medicaid for any reason will become the patient's financial responsibility.
Our fees are determined by considering a number of factors, including the time and complexity of the service as well as the cost of materials required and the associated technological costs. Fees are set at a level necessary to maintain quality services to our patients. Fees are reviewed on an annual basis to ensure we are competitive within our geographic market place.
The DeKalb Clinic asks that patients pay for medical services, at the time they are rendered, by cash, personal check, or credit card. However, we do understand the challenges of multiple medical bills. Please contact our business office staff and let us help you set up an individualized payment plan for your specific circumstances.
Each patient at their first encounter to DeKalb Clinic will be asked to pay a portion of their cost to establish their credit with the clinic. For most patients this would mean prepaying their first office visit. Patients who have a managed care plan with a designated copayment will be asked to pay their copayment at the time of service. If a patient has not seen any one of our physicians within the past three years they will be asked to reestablish their credit by complying with the current financial policy.
We have relationships with various area employers to provide workman's compensation examinations. We will be happy to perform this service if we have received prior approval from your employer. Please notify the receptionist at each visit so charges may be billed correctly.
Employment exams may be required for various occupations prior to beginning your employment. These charges will be the patients responsibility unless prior arrangements have been made to bill prospective employer.
If you are treated by one of our physicians at an outside facility, you will receive a bill from our physician and a separate bill from the outside facility. Examples of charges may include charges for outside laboratory testing, pathology reading or interpretation of test results.
Patients who use our Convenient Care Center after 6 pm on weeknights and 12 noon on Saturdays will be charged an after hours fee in addition to our standard fee.