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Information about Your Insurance

  • As a courtesy to our patients, the Pinehurst Medical Clinic will file claims with most insurance companies. It is, however, the responsibility of the patient to understand the benefits payable under their insurance coverage. The patient is also responsible for ensuring timely payment of all amounts due.

  • The Pinehurst Medical Clinic participates in many different insurance plans. It is the patient's responsibility to know if PMC participates in their plan. It is important to remember that a medical insurance policy is an agreement between the patient and the insurance company. It is the patient's responsibility to pay any deductible amount, co-insurance, or other balance not paid by the insurance company.

  • Patients should bring their INSURANCE CARD(S) with them for every clinic visit. Patients are asked to let the receptionist know if any insurance information has changed since their last visit.

  • Patients covered by a MANAGED CARE plan may be required to obtain a referral from their primary care physician in order to be seen by a specialist physician. It is the responsibility of the patient to ensure needed referrals are obtained. Failure to obtain needed referrals may result in the patient being responsible for paying the entire cost of the visit or procedure.

  • MEDICARE - Pinehurst Medical Clinic physicians accept Medicare assignment. Patients with Medicare, and no secondary insurance, will be asked to pay their annual deductible and 20% of the Medicare allowable charge at the time of each visit or service. Patients are responsible for any services not covered by Medicare.

  • MEDICAID - Medicaid patients who are between 21 years and Medicare age are responsible for a $3.00 co-pay which is to be paid at the time of the clinic visit. Carolina Access Medicaid patients must have prior authorization from their primary care doctor to see a specialist physician.

  • CHOICES OF PAYMENT -- Payment may be made with cash, personal check, MasterCard, VISA, or American Express. Patient Account Representatives are available to assist patients with any payment and insurance questions. Patients experiencing financial difficulties may meet with a Patient Account Representative to discuss alternate payment arrangements.