Financial Policy

Insurance Accepted

Payment is not due at the time of service but will be billed in accordance with the payor agreement. We accept most major insurance plans including Medicare Part B, Medicaid, and commercial PPOs/HMOs. Insurance coverage varies by plan. Medicare Part B typically pays for 80% after annual deductible, leaving 20% coinsurance + any copay from your secondary/supplemental plan.

Patient Financial Responsibility

Wound care services are billed to your insurance as a medical service. You are responsible for:

• Copays/Deductibles/Coinsurance: Vary by plan
• Non-covered services: Any service your insurance deems “not medically necessary”
• Out-of-Network costs: While most services are considered in-network while you are admitted, if we are deemed out-of-network with your plan, you may have higher out-of-pocket costs.

We’ll provide an estimate of your cost after verifying benefits whenever applicable but this is not a guarantee of payment. Final amounts are determined by your insurer.

Prior Authorization and Durable Medical Equipment (DME)

Some wound care treatments, dressings, or devices require prior authorization from your insurance company. We’ll start this process for you but approvals can take 3–14 business days. Treatment may be delayed until authorization is received. Supplies billed as Durable Medical Equipment may come on a separate statement from third parties.

No Surprises Act

Uninsured or self-pay patients get a good faith estimate upfront. If your bill is more than $400, you can dispute it under federal law.

Billing Questions

Contact our billing team, MedAlign Solutions at 309.304.2404 between 9 am and 5 pm CST or email us at operations@primeauxmedical.com. We bill insurance as a courtesy but you’re ultimately responsible for your account.