Billing & payment information

Healthcare billing can be confusing, expensive, and frustrating. Sol Vida Family Care understands that frustration and experiences many of the same challenges while navigating the insurance system on behalf of patients.

Sol Vida is a small, independently owned primary care practice committed to providing thoughtful, accessible healthcare while working within the existing insurance model. The practice intentionally does not charge membership, subscription, or concierge fees for access to its providers.

For that model to remain sustainable, however, Sol Vida must receive payment for the care and services it provides. The goal of this policy is to make that process as transparent, fair, and understandable as possible.

Sol Vida does not receive a salary from insurance companies simply because a patient is enrolled in a particular health plan.

Instead, Sol Vida is paid for the individual healthcare services it provides. Depending on a patient's insurance plan, payment for a service may come from the insurance company, the patient, or a combination of both.

The portion assigned to the patient may include a copay, deductible, or coinsurance. These amounts are determined by the patient's insurance plan—not by Sol Vida.

A copay is a fixed amount that an insurance plan requires a patient to pay for certain healthcare services.

When a health plan requires a copay, it is part of the payment for the care provided—not an additional fee charged by Sol Vida.

Sol Vida's contracts with insurance companies generally require the practice to make reasonable efforts to collect required patient cost-sharing, including copays. Routinely waiving these amounts may violate insurance contracts and, in some circumstances, applicable regulations.

For these reasons, copays are due at the time of service.

Many insurance plans now have significant deductibles. This can mean that even though a patient has health insurance, the patient may be responsible for much or all of the contracted cost of an office visit until the deductible has been met.

Sol Vida does not determine a patient's deductible, coinsurance, or how much of the deductible has been met.

When possible, Sol Vida may use information provided by the insurance company to estimate a patient's expected responsibility before or at the time of service. Estimated patient responsibility may be collected at the time of the visit.

This is only an estimate. Sol Vida will still submit the claim to the insurance company. Once the claim is processed, the account will be reconciled with the insurance company's final determination. Any remaining patient responsibility will be billed, and any overpayment will be credited or refunded as appropriate.

When Sol Vida is contracted with an insurance company, the practice agrees to accept that insurer's contracted rate for covered services.

For example, if Sol Vida charges $200 for a service but the insurance contract allows $130, Sol Vida writes off the $70 difference. That $70 is not billed to the patient.

This is called balance billing, and Sol Vida does not balance bill patients for covered services when prohibited by its insurance contracts or applicable law.

The patient may still owe the portion of the $130 contracted amount assigned by the insurance plan as a copay, deductible, or coinsurance.

Sol Vida is committed to keeping healthcare accessible and intentionally chooses not to add membership or concierge fees on top of what patients already pay for health insurance.

That commitment only works if the practice is paid for the healthcare it provides.

Patient payments help support the clinicians and staff providing care, medical supplies, vaccines and equipment, the physical clinic, technology, and all of the other costs required to operate a small independent medical practice.

Sol Vida cannot sustainably provide healthcare without receiving payment for its time and services.

Patients are therefore asked to pay the amounts they legitimately owe for the care they receive.

Patient balances are due within 30 days of the first statement.

Any balance that remains unpaid more than 30 days after it is due must be paid at or before the patient's next appointment, unless another arrangement has been approved.

An unresolved past-due balance may affect the ability to receive non-urgent services or schedule future appointments.

Patients who cannot pay a balance in full are strongly encouraged to contact the office. Sol Vida would much rather discuss the situation and determine whether an appropriate payment arrangement or financial hardship accommodation is available than allow a balance to remain unresolved.

Sending a patient's account to collections—or ending a patient-provider relationship because of an unresolved financial balance—is never Sol Vida's preferred outcome.

However, repeatedly providing services without receiving payment is not sustainable for a small independent practice.

When a significant balance remains unpaid and reasonable attempts to resolve it have been unsuccessful, Sol Vida may refer an eligible account to an outside collection agency. Continued refusal to address a legitimate outstanding balance may also result in dismissal from the practice.

Financial hardship alone will not automatically result in dismissal. Patients experiencing difficulty paying are encouraged to communicate with the office so that available options can be discussed.

Any collection or dismissal process will be handled in accordance with applicable insurance requirements and federal and New Mexico law.

Please ask.

Insurance companies sometimes process claims incorrectly. Information can be entered incorrectly. Coverage changes. Deductibles can be confusing. And sometimes a bill is correct but simply difficult to manage.

Sol Vida would much rather have a conversation about a bill than have a patient avoid care or ignore a balance because it feels overwhelming.

The practice's commitment is to bill accurately, never intentionally collect more than a patient owes, avoid balance billing, be transparent about charges, and treat financial concerns with kindness and respect.

In return, Sol Vida asks patients to communicate with the practice and pay the amounts they legitimately owe for the healthcare they receive.