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Insurance & Billing Information at KCBJ

Payment Policy

Payment is requested at the time services are rendered. We verify insurance coverage in advance and in accordance with your insurance contract, co-payments are due at the time of the visit. We do file insurance as a courtesy for our patients, but the responsibility of the bill does rest with the patient. This office cannot accept responsibility for collecting your insurance claim or for negotiating a settlement on a disputed claim.


Fees for services are sometimes unexpected, therefore we do accept Mastercard, Visa, and Discover credit cards. We offer online bill pay as well. If you have any questions or need to discuss further payment arrangements, please contact our billing department.

Workers’ Compensation

In all workers’ compensation cases, prior to being seen we must have a written acceptance of financial responsibility from the employer or their insurance company. If there was previous treatment for this injury, all records and X-ray images and reports are required at the time of the exam.


We provide a work status report at each visit. This form will be given to the patient at the visit and faxed to the appropriate case manager or insurance.

Health Insurance

We participate in most HMO-PPO plans and we accept assignment on Medicare patients.


We do not participate in any Medicaid plans. Patients can check with their insurance company to verify our participation and to check on their policies regarding referrals, precertification requirements, co-pays, deductibles, services covered, etc. You can also check here.


Feel free to check with us regarding participation as well. Co-pays must be paid at the time services are rendered, per both the patients and our contract with the insurance company. Primary and secondary insurance filing will be completed at no charge.


Injury can happen in many different ways and settings and we understand how difficult an unexpected injury can be. If your injury is another party’s liability, our bookkeeping department will check with your health insurance to see if they will subrogate (pay your medical claims and bill the liability insurance themselves). If not, we will require you to pay as you go, with a deposit up front. We will not bill 3rd party liability or accept an attorney lien. The patient is responsible for payment of services regardless of who is liable or being sued no matter what your attorney might advise.


If you are a Medicare patient and have been injured on someone else’s property, you will need to provide us with specific information about the injury circumstances. Medicare requires a specific form be completed for this situation and our front desk will assist you with completing the form.  The information needed includes the place of injury, date and time of injury, and whether or not any other parties will be filing any type of insurance for your injury.

Surgical Fees

You may receive a call regarding your insurance benefits prior to surgery from both our office and the facility where your surgery will be performed.  We make every effort to make you aware of estimated amount costs and require payment of the estimated prior to surgery.  Please contact our bookkeeping staff to discuss this further with secure messaging or contact them by phone.  Uninsured patients will need to discuss estimated costs with the bookkeeping office in advance of surgery. For your convenience we accept MasterCard, Visa, and Discover and offer online bill pay.

Prescription Medication

The best method of having a refill issued is to have your pharmacist contact our office. However we offer online refill request as well. Certain narcotic prescriptions cannot be called into a pharmacy by law. Please let us know in advance, and a written prescription, if appropriate, can be provided for you.


Prescriptions and refills are issued during office hours only. This means that our providers will NOT routinely write prescriptions or refills during the evening or weekend hours.

What to Bring to Your Appointment

Your health history is important. We have a couple options for you to complete the needed information.


First, we offer an online patient portal that allows you to complete forms electronically.


Next, if time allows we can mail you the forms and finally, you can always complete the forms on paper when you arrive, we just ask you arrive 15-20 minutes early to allow time to complete the forms.


When arriving for your first appointment, we will ask you to complete a couple signature forms. Please give any requested information as accurately as possible.


We will scan your insurance cards, Driver’s License or State ID cards and Military IDs on your arrival. In addition, we will take a picture of you to attach to your chart.


We also need to have each patient bring the following to their appointment:

A list of your Medications with Dosages and Allergies (if not completed online)
– X-ray reports and images or other test results regarding the current condition from Referring Doctor


Guardianship Consent to Treat Patient (if applicable). If you are appointed as a Guardian or Legal Representative for the patient, we will need your authorization to evaluate and treat that person as well as assistance in completing the forms required for our medical record. We need a copy of the Guardianship or legal authorization as well as your contact information.