patient resource center

Financial Policy & Agreements

The Ohio Institute for Comprehensive Pain Management, the office of Mervet K. Saleh, MD is a professional business providing health-related diagnostic and therapeutic services to its patients with the expectation of making the profit needed to financially support the day-to-day operations of the office, as well as new services for patients in the future.

A professional relationship requires honest financial accountability. This document reiterates the policy which Ohio Institute for Comprehensive Pain Management/Mervet K. Saleh, MD, will hold itself and its patients accountable.

Every professional service and associated expense rendered will be charged to the patient according to a fee schedule prospectively determined by OIFCPM. Contractual agreements with all insurances will be honored in good faith. No fee can be reduced or waived without the permission of the administrator, or his or her designee.

Payment for services rendered is due on the date of service and is part of the professional relationship. OIFCPM/Mervet K. Saleh, MD, reserves the right to request payment of the total negotiated fee on the date due unless directed otherwise by contract. Cash, MasterCard, Visa, or certified checks are acceptable methods of payment.

Co-payments and deductibles must be paid at the time of service, this is non-negotiable. Respectively, any self-pay patient is responsible for payment on the date of service.

Patients who incur a balance must make immediate payment when the amount is due. New balances must be paid at the next office visit!

Extenuating circumstances that may affect your ability to make payments must be discussed proactively at the time payment arrangements are made.

For patients paying on old balances these balances must be paid in a timely fashion. Payment arrangements can be made for a reasonable amount in order to pay the balance down as expeditiously as possible.

Monthly statements will be sent with amounts owed. After three monthly statements have been sent with no response, the account will be sent to collections.

We encourage you, as patients, to understand your insurance. Know what your co-payments and deductibles are, as well as, what might require pre-certification. OIFCPM will make its best effort to obtain necessary pre-certifications and approvals for requested procedures or therapies as required by contracted insurances to facilitate payment for requested procedures/therapy. Failure to obtain pre-certifications or approval from the insurance company does not mean the procedure is not medically necessary; in this instance, the patient may be financially responsible for services rendered. OIFCPM will file a claim with the appropriate entity in order to facilitate payment. Patients should contact insurance if you have an outstanding balance that has not been paid on in sixty days and you believe should have been paid by your insurance. If the matter is not resolved you will need to pay the account balance.

Non-urgent professional services may be delayed or terminated within the guidelines of good medical practice if a patient is noncompliant with the financial policy. Only the office manager or administrator can amend this policy.