Patients will be required to complete and acknowledge the following forms:
At the patient’s request, a copy of the advance directive will be placed in the medical record. For a copy of the advance directive packet, please click here.
Our policy requires that you provide 24 hours notice when you are not able to keep a scheduled appointment. You will be notified if you have two or more missed appointments. If you have missed two consecutive appointments JCMG will bill you $30 for the missed appointments.
Comments or Suggestions
JCMG welcomes your thoughts for continued quality improvement. Please use any of the following for issues or concerns:
1. Billing issues contact the Billing Office
2. Clinic related issues contact the Department Coordinator or Quality Coordinator
3. Suggestion box in the Lobby of the JCMG Medical Building.
4. Contact us on the web at firstname.lastname@example.org
• JCMG participates with Medicare. Insurance claims will be filed and payments will come directly to JCMG. If applicable, secondary insurance will be filed. Any remaining, co-insurance, deductible, and non-covered services, will be billed to the patient by JCMG.
• JCMG participates with Medicaid. Co-payments will be collected at the time of service. Insurance claims will be filed and payments will come directly to JCMG. Any remaining spend down and non-covered services will be billed to the patient by JCMG. Medicaid patient failing to present a current Medicaid card will be responsible for their charges at the time of service.
• JCMG participates with many insurance plans. If a patient’s insurance is one of JCMG’s participating plans, the patient is responsible for the co-payment, deductible or co-insurance at the time of service. JCMG will file the claim, and payments will come directly to JCMG. Any remaining balances and non-covered services, will be billed to the patient by JCMG.
• If JCMG does not participate with an insurance plan, patients are responsible for 100% of the billed charges to be paid at the time of service. JCMG will provide the patient with an itemized statement/claim to file with the insurance company.
• Self-pay patients are expected to pay when services are rendered. JCMG offers a 25% discount if paid in full at the time of service. Exceptions include: Weight Treatment Center, Pharmacy, Sports physicals, DOT physicals, 3D ultrasound, CT Angiogram, Hearing Aids and cosmetic products and services.
• Patients will receive a separate bill for services rendered in the Outpatient Surgery Center.
• A separate bill may be sent for laboratory services that are processed by an outside laboratory.
• JCMG’s Radiology services function as an independent diagnostic facility with equipment in multiple departments. Therefore, patients may be responsible for additional co-payment for radiology services, whether in the physician office or in a separate facility depending on your insurance plan.
• The JCMG Billing Office is open 8 a.m.–5 p.m., Monday–Friday. Patients may call 573-556-5791, with billing questions. For your convenience, JCMG accepts Visa, MasterCard or Discover, cash, check or money order for payment.