Financial Policy
Welcome, and thank you for choosing Priority 1 Urgent Care for your urgent healthcare needs. We are committed to giving you the best possible medical care. To best achieve this goal, we need your assistance and understanding of our financial and payment policy. With that being said, it is critically important to understand that ultimately, it is up to you, the health care consumer, to know your insurance benefits.
1. INSURANCE: We participate with Medicare and with most major health insurance plans. If you are insured under a plan we do not participate with, or you do not have health insurance, payment in full will be expected for your visit at the time services are rendered. Our no-insurance discounted rate is a minimum of $195.00, and depending on the complexity of the visit, may increase as per the Priority 1 Urgent Care Self-Pay Policy. If you have coverage that we do not participate with, you are responsible for submitting your own claim to your insurance carrier for any potential reimbursement. Understanding your insurance benefits is your responsibility. If you are unsure about your benefits or participation with your plan, please be sure to call the telephone number listed on your insurance card, prior to engaging with Priority 1 Urgent Care. If your insurance changes, it is your responsibility to notify us at the time of your visit so we can make the appropriate changes to your account information to assist you in receiving your maximum benefits.
2. PROOF OF INSURANCE AND IDENTITY: All patients must complete patient registration as well as any other required forms prior to being seen by us for care. If you are insured by a plan we participate with, you must have a valid insurance card member ID and a valid state-issued identification, driver’s license, student ID, or passport, which we can photocopy and keep on record. If we are unable to verify your identity, we are unable to provide care for you.
3. CO‐PAYMENTS AND DEDUCTIBLES: Your medical insurance carrier may require that you pay a co‐payment or coinsurance amount for your visit. It is our policy to collect all co-payments prior to you being seen.
4. BALANCES AND CREDITS: Any and all outstanding balances must be paid before being seen again. If you have a refund due to you, we will send you a check within 90 days of receiving full payment for that service date.
5. NON‐COVERED SERVICES: Please be aware that some, and possibly all, of the items or services you receive may not be a covered benefit under your insurance plan. Your insurance benefits are determined by the insurance plan chosen by you and your employer and by how much you and/or your employer pays for your coverage. It is your responsibility to contact your insurance company if you have any questions or concerns about your coverage. It is also your responsibility to provide payment in full for any non‐covered items or services. Please be aware that if you come to be seen for a problem that has already been evaluated at another urgent care practice on the same calendar day, we are forbidden from billing private or government health insurance for an additional same day visit. We are happy to provide evaluation and care for you, but the visit must be paid for as per our Self-Pay Policy.
6. CLAIMS SUBMISSION: If we are a participant with your plan, it is our policy to submit your claim to your insurance company. It is sometimes necessary for either your insurance company or our billing department to contact you directly for information or assistance in processing a claim. It is your responsibility to comply with this request in a timely manner. Please understand that the balance of your account is your responsibility whether your insurance company pays your claim or not. It is in all parties’ best interest to expeditiously cooperate in the processing of your claim. We ask that you review all correspondence carefully and contact your insurance company or us immediately regarding any questions or concerns. If we do not receive full payment from your insurance company within 45 days from the date of submission, the entire balance owed may become your responsibility.
7. PAYMENT CARD ON FILE: The Priority 1 Urgent Care Payment Card on File (PCOF) system allows for smoother transactions and visit billing, and is designed to guarantee payment for services rendered that may not be completely covered by insurance, including charges applied to a patient’s deductible. Signing up for PCOF is simple. When a patient visits, the patient swipes their payment card of choice (Medical Flexible Spending, Debit, or Credit) and signs a prior authorization form giving us permission to keep card information on file. A copy of the signed form is saved into the patient’s electronic medical record. The patient’s payment card information is safely held on a secure encrypted gateway site that is completely compliant as required by law; no financial information will be available to our staff, held in our system, or kept at our office. Co-pays will still be collected at each visit and can be paid in any manner the patient chooses at that time. If the patient has medical insurance contracted with Priority 1, we will submit the claim to insurance on behalf of the patient as usual. Once the claim is submitted to and processed through insurance, and in approximately 2 to 3 weeks following the visit, the patient should receive an Explanation of Benefits (EOB) notice from their insurer that tells the patient exactly, according to the terms of the patient’s health insurance coverage, how much of the urgent care bill is covered by insurance and how much the patient owes to our practice. Priority 1 will also receive a copy of the same EOB from the insurer that the patient was sent, and determine what the insurance carrier has decided is the patient’s responsibility to pay. Once we receive the copy of the EOB, the patient will be notified of the outstanding charge via a patient-provided email address or text message. One day after notice is sent via email or text, the payment card on file is charged and any remaining patient-responsible amount is collected at that time. For any questions regarding this practice, the Billing Office can be reached at 833-212-4040. Please note, the Priority 1 Urgent Care email or text message sent to the patient is considered notification of an impending charge against your payment card. If there is no balance due, the payment card will not be charged. More information about the Payment Card on File program can be found in our FAQ.
8. NON-PAYMENT: As a courtesy, we will provide you with statements of your account. It is your responsibility to review these statements for accuracy and respond immediately to any and all requests for information and payment. If you have not received a statement from Priority 1 Urgent Care within 30 days of your visit, please call us to confirm your billing information. We are required, by federal law, to support all services rendered with proper documentation in your medical records. We cannot alter a claim to obtain payment unless there has been a documentation error. If you discover an error, duplicate charge, or have any concerns about your bill, please immediately contact our billing department (833-212-4040) for evaluation and proper corrective action. All outstanding balances are due upon receipt and become past due 30 days later. A $5.00 monthly service charge ($60.00 per year) will be charged on accounts overdue past 60 days and accounts 90 days past due may be subject to collection action pursuant to the full extent of the law. Please understand that in the event that your account is referred to collections you will be responsible for any additional costs attributable to that action including, but not limited to, agency, attorney, and court costs incurred and permitted by the laws governing these actions. Please be aware that you may be refused service in the future due to non-payment/non‐compliance with payment collections activities.
9. ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES: We will enforce your privacy rights to the full extent of all local, state and federal laws and maintain the privacy of your personal health information. At your request, we will provide you with a Notice of Privacy Practice, which further describes this policy.
10. WORKERS COMPENSATION: If you have an injury which occurred while at work, we will submit a claim on your behalf and seek payment for our services from your employer’s worker’s compensation insurance carrier. In order to process a workers compensation claim, at the time of your visit, you are required to provide the following information:
the date of your injury
your employer’s name/address/telephone number
the name of your supervisor or person to contact regarding your injury
the name of your employer’s worker’s compensation carrier
the worker’s compensation claim number.
If you are not able to provide us with the name of the worker’s compensation carrier during your visit with us, we are still able to provide care for you but your visit must be paid for under our Self-Pay Policy, payment for which is due at time of service. You must inform your employer of your injury prior to being seen by us. If your injury occurred at work, it is illegal to bill private or government health insurance, and we are not able to change our documentation once you have reported to Priority 1 staff that your visit was due to an injury that occurred at or was related to the workplace. If your claim is denied for any reason, or if your employer fails to file your claim in a timely fashion, you will be held responsible for the full payment for the services rendered. If you have ever been treated for your condition before coming to Priority 1, we will not be able to assume care for that injury or condition. If your claim is rejected due to errors in the information you provided, you will be responsible for all associated charges.
11. MOTOR VEHICLE/NO‐FAULT LAW: If you were injured as a result of an automobile or motorcycle accident which occurred in New York, we will seek payment for your services from the car insurance carrier of the owner of the involved vehicle/vehicle you were riding in, regardless of who was at fault for the accident. If you are the vehicle owner, you are required to give us a copy of your car insurance card and your insurance claim number. If you were not the owner of the vehicle, we require you to provide us with the vehicle owner’s car insurance name, medical claim’s address, policy number, and claim number at the time of your visit. If you are unable to provide us with No-Fault information we can still provide care for you but your visit must be paid for under our Self-Pay Policy, payment for which is due at the time of service.
12. THIRD PARTY LIABILITY: Injuries that did not occur at work or did not involve a motor vehicle, and were caused by a third party whom you think should be responsible, will be considered Third Party injuries. Some examples of third party injuries are injuries that occur at stores, restaurants, or on sidewalks, and a third party may or may not be responsible, and/or liable. Priority 1 Urgent Care will not seek payment from the third party on your behalf.
13. MINOR PATIENT: If the patient is a minor, the responsible adult accompanying the child for treatment is ultimately responsible for payment of care rendered to the minor.
14. MEDICAID: We do not participate with Medicaid Insurance. We are happy to provide care for you if you choose to pay the Priority 1 Self-Pay rate, but by signing this Financial Policy, you are acknowledging that, prior to treatment, you were notified that we do not participate with Medicaid. As such, you understand that Medicaid neither pays for your treatment at Priority 1 Urgent Care nor reimburses you for these services. You agree to pay for these services today in full as per the Priority 1 Urgent Care Self-Pay Policy.
15. COVID-19: Although there is never a guarantee of coverage with health insurance, if a COVID test is ordered by the Priority 1 Urgent Care doctor as part of a related regular medical urgent care visit, the cost of the test will most likely be covered by health insurance. However if your visit is specifically to obtain a COVID-19 screening test without being seen by our doctor for a related medical problem, you understand and agree that the test cost will not be covered by health insurance. Priority 1 Urgent Care will not submit any claims to insurance for non-doctor ordered COVID-19 testing.
Thank you for taking the time to review our Financial Policy. Please let us know if you have any questions or concerns.
HIPAA Notice Of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our Pledge Regarding Medical Information
We are committed to protecting medical information about you. This notice describes our privacy practices and that of all our employees and staff. This notice will tell you about the ways in which we may use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information. We are required by law to:
Give you this notice of our legal duties and privacy practices with respect to medical information about you;
Make sure that medical information that identifies you is kept private; and
Follow the terms of the notice that is currently in effect.
How We May Use and Disclose Medical Information about You
The following categories describe different ways we use and disclose medical information. For each category we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
Treatment. We may use and disclose medical information about you to provide you with medical treatment or services. For example, a specialist we may refer you to may need to know about a treatment you received at our office in order to coordinate other treatments you are receiving.
Payment. We may use and disclose medical information about you so that the treatment and services you receive at our office may be billed and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about services you received at our office so your health plan will pay us or reimburse you for the services.
Health care operations. We may use and disclose medical information about you for our office operations. These uses and disclosures are necessary to run our office and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
Appointment reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at our office.
Treatment alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
Health-related benefits and services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
Individuals involved in your care or payment for your care. We may release medical information about you to a close personal friend or family member who is involved in your medical care or payment for your care, so long as you have not objected and it is reasonable for us to infer that such disclosure is in your best interest.
Special purposes when permitted or required by law. We may disclose medical information about you for special purposes when permitted or required by law, when certain elements are met, including the following:
To avert a serious threat to health or safety against you, the public or another person.
For public health and administrative oversight activities such as disease control, abuse or neglect reporting, health and vital statistics, audits, investigations, and licensure reviews.
For organ and tissue donation and transplant to facilitate organ or tissue donation and transplant.
For research purposes limited information may be disclosed as permitted by law.
To workers’ compensation or similar programs for the payment of benefits for work-related injuries.
To coroners, medical examiners and funeral directors to identify a deceased person, determine cause of death, or to carry out duties.
To comply with court orders, judicial proceedings, or other legal processes related to law enforcement, custody of inmates, legal and administrative actions, and criminal activity.
For U.S. military and veteran reporting regarding members and veterans of the armed forces of U.S. or foreign military.
For national security and intelligence activities such as protective services for the president and other authorized persons.
State and other federal laws. We will comply with all applicable state and federal laws. For example, under state law, there are more limits on the disclosure of HIV and AIDS information. We will continue to abide by all applicable state and federal laws.
Other uses of medical information require an authorization. Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us an authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by the written authorization. You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provide to you.
Your Rights Regarding Medical Information About You
You have many rights with regard to your medical information. If you wish to exercise any of these rights, you must submit your request in writing, unless otherwise noted.
Your right to inspect and copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. We may charge a reasonable fee for the costs of copying, mailing or other supplies associated with your request, up to the maximum allowable in the State of New York.
Your right to amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to add a statement. You must provide a reason that supports your request for an amendment.
Your right to an accounting of disclosures. You have the right to request an “accounting of disclosures.” This is a list of certain disclosures we made of medical information about you. Your request must state a time period. We may limit the time period to 6 years and to disclosures made on or after April 1, 2019. The first list you request within a 12-month period is free. For additional lists, we may charge you for the costs of providing the list.
Your right to request restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you. For any services for which you paid out-of-pocket in full, we will honor any request you make to restrict information about those services from your health plan, provided that such release is not necessary for your treatment. In all other circumstances, we are not required by law to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.
Your right to request confidential communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. If we maintain medical information about you in electronic format, you also have the right to obtain a copy of such information in electronic format and to direct us to transmit such information directly to an entity or person clearly, conspicuously, and specifically designated by you. We will not ask you the reason for your request. You may make this request in writing or verbally.
Right to paper copy of this notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time.
Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with us. You may also file a complaint directly with the secretary of the department of health and human services. You will not be penalized in any way for filing a complaint.
Changes To This Notice
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice at our offices and make copies available upon request.
Privacy notice contact information
For questions about this privacy notice, please contact:
Priority 1 Urgent Care Privacy Officer
2080 Western Avenue, Box 132
Guilderland, New York 12084
Telephone 518-867-8040
info@priority1urgentcare.com
Website Privacy Policy
Priority 1 Urgent Care respects your privacy and is committed to protecting any personal information that you share with us. We will do our best to provide a convenient and safe online experience. This Privacy Policy describes what information we collect, why we collect it, how we may use it and when we share it with third parties. By accessing our website, you acknowledge and agree to be bound by the terms hereof. Periodically, we may update this Privacy Policy and encourage you to check this section for any changes.
What information do we collect, why do we collect it and how do we use it?
When you browse our website, you do so anonymously. You are not required to provide any personal information about yourself, and we do not collect any personal information (if volunteered by you) for the purpose of reselling or distributing that information.
We may, however, collect non-personal information such as your IP address (the Internet address of your computer) when you log in to our website to give us an idea of which part of our website you visit and how long you spend there. We do this in an effort to improve your online experience and to help us better improve our website and interaction with our communications to users of our site.
Like many other commercial websites, the Priority 1 Urgent Care website may use a standard technology called a “cookie” to collect non-personal information about how you use our site. A cookie is a small data file that certain websites write to your hard drive when you visit them. A cookie file can contain information such as a user ID that the site uses to track the pages you’ve visited, but the only personal information a cookie can contain is information you voluntarily supply yourself. A cookie can’t read data off your hard disk or read cookie files created by other sites. Some parts of Priority 1 Urgent Care’s website use cookies to understand user traffic patterns. As mentioned above, we do this in order to better determine the usefulness of our website information to our users and to see how effective our navigational structure is in helping users reach that information. If you prefer not to receive cookies while browsing our website, you can set your browser to warn you before accepting cookies and refuse such cookies when your browser alerts you to their presence. You can also refuse all cookies by turning them off in your browser, although this may result in you not being able to take full advantage of the Priority 1 Urgent Care website if you do so.
Who do we share your information with?
Any personal information you provide on our website is never shared outside Priority 1 without your permission, except under certain conditions explained below. Priority 1 only stores data in controlled servers with limited access.
Priority 1 may send your personal information to other companies or people under any of the following circumstances: when we have your consent to share the information; we need to share your information to provide the product or service you have requested; we need to send the information to companies who work on behalf of Priority 1 to provide a product or service to you (we will only provide those companies the information they need to deliver the service, and prohibit them from using that information for any other purpose); or we want to keep you up to date on the latest product announcements, software updates, special offers or other information we think you’d like to hear about either from us or from our business partners. We will also on rare occasions disclose your personal information if required to do so by law (such as subpoena, court or agency orders) or as we may reasonably determine to be necessary to enforce our Privacy Policy or other terms of use associated with our website, or in urgent circumstances, to protect personal safety, the public or our website. In addition to the foregoing, Priority 1’s website may contain links to other sites that are not owned or operated by Priority 1. Priority 1 does not share your personal information with those websites and is not responsible for their privacy practices. We do not warrant, represent or assume any responsibility or liability for the accuracy, security, completeness or operation of any linked site. We encourage you, therefore, to familiarize yourself with the specific legal, privacy and security information contained in any such linked sites.
How do we protect your information?
Your Priority 1 Urgent Care account information (if offered and should you choose to have one) is password-protected for your privacy and security. Priority 1 safeguards the security of the data you send us with physical, electronic, and managerial procedures. While we strive to protect your personal information, we cannot ensure the security of the information you transmit to us, and so we urge you to take every precaution to protect your personal data when you are on the Internet. Unfortunately, no collection or transmission of information over the Internet can be guaranteed to be 100% secure, and therefore, we cannot ensure or warrant the security of any such information. To mitigate the risks of exposure, we encourage you to change your passwords often, use a combination of letters, numbers, and non-alphanumeric characters, and make sure you always use a secure browser.
Our website does not target and is not intended to attract children under the age of 13. Priority 1 does not knowingly solicit personal information from those we actually know are children under the age of 13 or send them requests for personal information. If you are under 13, you should not submit any personal information to us. If you are the parent of a child under 13, please help us protect your child’s privacy by instructing them never to provide personal information on our website or any other site without your permission.
Updates and Contact Information
As mentioned above, Priority 1 Urgent Care may amend this Privacy Policy from time to time. We encourage you to check this section for any changes.
If you have questions or concerns about your privacy or security at our website, please email us at info@priority1urgentcare.com.
Disclaimer
This website is for informational and educational use only. No physician/patient relationship is established by your use of this site, or by you accessing this site, and no diagnosis or treatment is being provided. The information contained herein should be used only in consultation with a physician of your choice, and should in no way be used instead of or in place of consulting your physician directly. No guarantees or warranties are made regarding any of the information contained within this website.
This website is not intended to offer medical or other professional advice to anyone. Priority 1 practices medicine in the State of New York and this website is not intended to solicit patients from other states. Further, this website and its owners take no responsibility for any websites hyper-linked to this website.