Alan E. Oshinsky, M.D., P.A and Ileana Showalter, M.D. require a credit/debit card to be kept on file with our office.

Dear Valued Patients:
We have discontinued mailing patient statements by U.S. Mail. We are now using email delivery of statements and receipts, and electronic billing to credit and debit cards.

How will I know how much you’re going to charge me?
You will receive an Explanation of Benefits (EOB) from your insurance company. The EOB explains exactly how much of the cost of your services will be paid by insurance and how much is your responsibility to pay. At any time, you may also view a complete copy of your billing ledger on our web portal, www.aoiswebportal.com.

Then what?
We receive the same Explanation of Benefits (EOB) from your insurance company. The amount that is your responsibility will be charged directly to your credit/debit card. For balances over $150.00, we will notify you by email prior to charging your credit/debit card. We will send you a copy of your receipt via email.

But wait, I’m nervous about giving you my credit/debit card information!
We do not store your credit/debit card number in any form at our office. The card information is encrypted and securely stored on a website called a gateway. We use this gateway to process payment(s).

What if I need to dispute my bill?
We are always happy to discuss any questions or concerns that you may have about our billing. If we have made an error, we will happily and promptly process a refund to your card.

Web portal username and password:

www.aoiswebportal.com


Authorization for Credit/Debit Card on File Payment

Until further notice, I authorize Alan E. Oshinsky, M.D., P.A. to charge the patient-responsible balance(s) to my credit/debit card on file.
This card will also be used for any missed appointment fees charged to your account. You may revoke this authorization at any time.

Upload card.



I understand that once insurance has processed the claim for my services and paid their portion, I will receive an Explanation of Benefits (EOB) from the insurance company.
The EOB will state any balance remaining that I am responsible to pay. I agree that Alan E. Oshinsky, M.D., P.A. may charge my credit/debit card on file for the balance due when they receive the Explanation of Benefits.



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