Office Policies


female7.jpgThe team at Bucks Rehabilitation Specialists (BRS) is dedicated to providing the best possible care. It is important that care is rendered cost effectively so the practice remains operational. Our professional fees have been determined through careful examination and are reasonable and customary within our geographic area. We ask your cooperation and understanding with our financial policies. It is important to understand the terms of your specific insurance coverage and your financial responsibilities under your insurance coverage. Our staff is trained and available to assist you with understanding your coverage, and is pleased to answer any questions you may have concerning a bill.

Methods of Payment

  • BRS accepts cash, personal check, money order, Visa, MasterCard, Discover, and American Express
  • You may pay your account over the telephone utilizing your credit card by calling 215-968-4901 extension 106 (our voicemail is available 24 hours a day, 7 days a week)
  • A Patient Pay Consent Form is utilized as necessary in order to keep a credit card number on file to be used for future unpaid balances (the same process utilized by hotels, rental car agencies, etc.)
  • There is a fee of $30 for any returned checks

At Each Appointment - Items to Bring/Notifications to Make

  • Health Insurance Card
  • Driver’s License or Other Government Issued Photo ID as well as utility bills/other correspondence which shows address of current residence if the photo ID doesn’t show the address or shows only a P.O. Box
  • Method of Payment
  • Notification of Changes to Address/ Telephone/Demographic Information/Attorney/ Insurance Coverage
  • Notification of Motor Vehicle Accident/Work Accident occurring since last visit
  • Notification of relocation to a Skilled Nursing Facility or Nursing Home
  • Notification of the receipt of home care or hospice

Failure to notify us of such changes/incidents may result in your being responsible for payment of services.


  • Must be received prior to visit. Appointments are rescheduled if referrals have not been issued.
  • Back-up referrals are required for Workers’ Compensation (WC) and Motor Vehicle Accident (MVA) patients with health insurance which requires referrals. These referrals must be received prior to the visit. The health insurer is billed in those instances wherein the workers’ compensation carrier denies, contemporaneously or retroactively, payment for our services, or the motor vehicle coverage exhausts. Appointments are rescheduled if referrals have not been issued.


  • All past due balances, copays, coinsurances, and deductibles are to be paid on the day of service at the time of check-in. If the exact amount of deductible/coinsurance owed is not able to be determined a down payment of $50 is required on the day of service.

Payment of these is required at the time of check-in due to the busy nature of the check-out process. Copays are never billed nor waived as we are legally obligated through our contract with the insurers to collect them at the time of service. If you receive more than one type of service on the same day, you may be responsible for more than one copay.

Participating Insurances and Balances

  • The billing staff of BRS will file all claims for services rendered to insurance carriers with which BRS PARTICIPATES. Statements are issued to patients for balances due after the insurance carrier has processed the claim. Balances must be paid in full within 30 days of receipt of BRS’ statement.
  • Three statements may be issued by BRS. If the account is not paid or addressed by the time of the fourth statement at the latest, your account may be turned over to a collection agency.
  • Financial problems may at times affect timely payment of your account. If such problems arise, please contact Shannon at 215-968-4901 extension 106 for assistance in the management of your account. Payment plans are readily available.

Non-Participating Insurances

  • If we DO NOT PARTICIPATE (out- of- network) with your insurance plan, payment-in- full is expected at the time of service. An itemized bill and receipt will be provided for you to submit to your insurer for reimbursement directly to you.

Self-Pay Patients

  • We offer the same discount to self-pay/uninsured patients as we offer to insured patients if the bill is paid-in-full at the time of service. If the bill is not paid-in-full at the time of service, the standard charge schedule applies, and must be paid within 60 days.

Payment Plans

  • We are happy to work with you in order to pay any balance due to our practice.
  • If you are a self-pay patient and/or are experiencing financial hardship or other extenuating circumstances, payment plans are available. Such plans should be requested prior to treatment. Please contact Shannon at 215-968-4901 extension 106.
  • Please allow 5 mail days prior to each due date for payments to be received.
  • Patients on payment plans are permitted one month’s grace period. If no payment is received by the next month, the account may be turned over to the collection agency.


There is a charge of $10.00 for a single-page form and $30.00 for each multi-page form up to 4 pages. Additional pages are $5.00 each up to a maximum form fee of $50.00. The standard turnaround time for forms is 10 business days after receipt of the form. Payment is due when the form is dropped off/ mailed in for completion. An additional fee of $20 is due for any form that needs to be expedited (5 to 7 business days). Forms include:

  • Disability forms
  • FMLA forms
  • Life insurance/disability insurance forms
  • Employments forms/ letters
  • Driving privileges forms

We are unable to complete forms for patients who have not been seen within 9 months. In certain cases, the only way for the physician to complete the form is for the patient to schedule a follow-up appointment.

The completion of forms is considered a NON-COVERED benefit by your insurance carrier. As a result, the form fee is due and payable by the patient and is distinct and separate from other fees such as copays, coinsurances, deductibles, etc.

Please refer to the Financial Responsibility Policy on methods of payment and payment plans if required.

Prescription Refills

A minimum of 3 business days’ notice must be given to process prescriptions that have to be written by the physician for either pick-up and /or phone-in to a pharmacy. Business days include Monday, Tuesday, Wednesday, Thursday and Friday. Take note that we are closed on Saturday, Sunday, and the following holidays: New Year’s Day, Presidents’ Day, Good Friday, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day and the Friday after, Christmas Eve Day and Christmas Day. Days the office is closed ARE NOT considered business days.

Make a point to take note/calculate the date when your medication will run out. If you do not have an appointment scheduled with Dr. Bernal before your medication will run out, this policy will apply to you. You must pay attention to the date your medication will run out in order to give yourself ample time 1) for your refill request to be processed by this office, 2) for you to come pick up your prescription and 3) for you to go to the pharmacy to have the prescription filled, if applicable.

We do not refill prescriptions early. This means that if you have been taking more medication than prescribed and run out before the expected date according to the prescription and our records, Dr. Bernal may not renew your prescription unless you are seen in person for an appointment.

If you are taking the medication as prescribed, due to our inability to postdate prescriptions, you may only pick up your prescription (which has been called in to the office for processing with 3 business days’ notice) within 3 business days of the date you will run out of your prescription.

Test Results (MRI, CT Scan, X-Rays, Labwork)

Test results are provided at the time of the follow-up appointment, which is scheduled two to three weeks after Dr. Bernal orders any testing. Test results are not routinely given over the telephone.

Notice Of Privacy Practices (HIPAA)

Please download our Notice of Privacy Practices

Pain Medication Agreements and Urine Testing

To protect your access to controlled substances and your safety, and to protect our ability to prescribe for you, Bucks Rehabilitation Specialists has a Pain Medication Agreement which every patient who is prescribed narcotics is required to complete.

In addition, random urine testing will be performed on all patients taking narcotic medications to ensure the patient’s safety and well-being. Long-term use of opioids, benzodiazepine, tranquilizers and barbiturate sedatives is controversial because of uncertainty regarding the extent to which they provide long-term benefit.

There is a risk of an addictive disorder developing or of a relapse occurring in a person with a prior addiction. The extent of these risks is not certain.

These drugs have potential for abuse and diversion. Strict accountability is necessary when use is prolonged. Remember, your care and protection are very important to us.