Chetan Hampole, MD, FACC Office and Other Patient Information
Preparing for your visit
If you provide your insurance information, we will file your insurance claim for you. Please note that you will be responsible for any co-pay, co-insurance, deductible, or non-covered services at the time of each visit. If you arrive for a visit without your co-pay, referral, authorization number, insurance card(s) or driver’s license, the appointment will be rescheduled. You also will be asked to sign a form to authorize your insurance company to pay our office directly.
Depending on the type of insurance you have, you may have an annual deductible to meet. Our office will make every effort to verify your insurance benefits prior to your visit. When we call to confirm your appointment, we will inform you of the deductible. You will be asked to pay the deductible at the time of service.
Out of Network Services
Some insurance plans allow you to go out of network to see a provider without a referral. Usually, you will have a deductible to meet and a higher percentage to pay "out of pocket.”
Referral or Authorization
Many insurance plans require that you obtain a referral from your primary care physician (PCP) before you see a specialist. Therefore, we ask that you call our office prior to your visit to confirm that your PCP has provided us with a referral. Depending on your particular plan, the referral may be good for one year or only two visits, so please verify the number of visits permitted. You will be responsible for any visit not authorized.
A patient with a balance that has been placed in collections must pay any balance owed to the practice in cash before the practice will see them again.
Paying Your Bill
To determine the type of bill that you’ve received, please follow the instructions below:
A hospital bill is for patient service provided at a Baptist hospital or outpatient facility. (room & board, diagnostic testing, medical supplies or medications).
Baptist Heart Specialists Doctor Bill
A doctor bill may either be for services provided at an office visit or for a service or consultation provided by a physician at a Baptist hospital or outpatient facility.
If you receive a physician bill, please follow the instructions below.
Online Bill Payment
For your convenience, you may view or pay your bill using our online bill payment service and request e-statements.
Bill Payment by Mail
Please mail payments to:Baptist Heart Specialists Billing Office
PO Box 43667
Jacksonville, FL 32203
Bill Payment by Phone
A customer service representative will be happy to assist you with any questions that you have regarding your bill. You may also pay your bill over the phone during normal business hours.
We accept cash, check, MasterCard, Visa or Discover