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Annual Enrollment Fee

The patient’s annual enrollment fee is paid in advance, starting the day the agreement is signed. This may be paid yearly or in installments (for example, once a month, every two months or every six months).

Annually
or
Monthly Installments
64 and under
$1,500
or

$125

65 and over
$2,400
or
$200

The Annual Enrollment Fee is not a covered benefit under any insurance company, so insurance companies will not pay for the fee—it is the sole responsibility of the patient. 

The fee may change with advance notice to the patient.

Insurances accepted: all PPOs and patients without insurance.
Insurances not accepted: all HMOs, Medi-Cal and Worker's Compensation insurances.

Patients with Medicare are accepted. The Annual Enrollment Fee is not covered by Medicare. Those enrolling prior to age 65 will not have their fee increased when they reach age 65.


Payment Policies:

Members of Hansen-Smith Family Medicine have full access to the doctor from the day they register with the practice--whether they are seen by the doctor or not. Payment of the fee is expected from all patients--whether or not they contact or are seen by the doctor.

Initial payment is due upon registering in the practice and can be paid with check, cash or credit card (Visa, MasterCard, American Express and Discover are accepted).

A Late Fee of 10% of the monthly fee will be applied to the statement for the month following the late payment.

A $10 Returned Check Fee will be assessed.

It is not Dr. Hansen-Smith's policy to deny treatment to patients if they are slightly behind in their payments. However, it is expected that payment will be made in a timely manner. Occasionally a member may get behind in their payments, and a schedule of payments may be agreed upon to help the member catch up. If no attempt to contact the office to arrange payments is made within 4 months of the first delinquent date, the patient will be dismissed from the practice and collections will be initiated.


Cancellation Policies:

The agreement usually renews automatically each year, but the patient or the doctor may cancel the agreement instead of continuing with the patient-physician relationship in the practice.  If the patient has pre-paid the fee beyond the cancellation date, Hansen-Smith Family Medicine will refund the part of the fee paid but not used, rounded-up to the next month.  Any past-due fees owed to the practice at the time that Hansen-Smith Family Medicine is notified of the member's cancellation are still owed to the practice.  Hansen-Smith Family Medicine reserves the right to cancel this agreement for nonpayment of fees.

Once a patient has cancelled the agreement, the doctor will assume that the patient will not return to the practice unless arranged in advance.