414 W Virginia Ave Effingham, IL. 62401      Call us at 217.342.9738      Fax: 217.342.9806

General Policies


Medical practices need to have policies and procedures to help them guide the actions of all individuals involved in the service. They ensure and endorse the well-being of all patients, staff and everyone who is connected to the practice. Our policies are meant to establish a professional and effective organization, and to provide consistency amongst staff, patients and everyone involved.


Discontinued Patients

Effingham Urology reserves the right to discontinue a patient for any reason, listed below are the primary reasons we discontinue patients.

  • Failure to make payments on account.
  • Failure to keep appointments, this includes no showing appointments as well as cancelling and reschedule appointments on more than 3 occasions.
  • Being rude to staff, nurse practitioners, and physician.
  • Failure to comply with recommendations.
  • Falsifying prescriptions.
  • Falsifying FMLA forms.


If a patient is discontinued, they must complete a new patient form to be approved as a patient here again.


Payment Policies


Collection Policy

  • Effingham Urology Associates does allow patients to make payments on their account.
  • We do not charge interest on balances
  • We do not require a set amount each month
  • We DO require a payment to be received every 30 days.
  • Patients will receive statements every month on balances
  • Patients will receive 2 statements before being considered delinquent
  • Patient will receive a reminder letter they have a balance and to please send payment.
  • If payment is not received within 30 days of reminder letter, patient will be sent to collections.
  • Once patient is sent to collections they will be discontinued from practice and we will no longer provide them with care.
  • If patient would like to continue to be seen, payment must be made in full and new patient form must be submitted and approved by Dr. Nayak prior to any appointment being made.
  • If patient has received any hardship discount and fallen behind on payments, this discount will be revoked and the entire balance will be sent to collections.
  • Once account has been sent to collections, the patient must correspond directly with the collection agency, Effingham Urology will no longer accept payments from the patient.

Overpayment Policy

If Effingham Urology Associates is overpaid by an insurance company, the following steps will be taken:

  • We will investigate the claim to locate the discrepancy.
  • We will refund the insurance company within 30 days of the overpayment.


If Effingham Urology Associates is overpaid by a patient, the following steps will be taken:

  • We will investigate the difference.
  • We will refund the patient on the next check run for any overpayment that has already been deposited.
  • If the check has not been deposited it will be mailed back to the patient.


Self Pay Policy

  • Must pay $200 at first appointment.
  • Can make payments on remaining balance from first appointment.
  • No additional appointments can be made until the balance from the first appointment is paid in full.
  •  All emergency surgeries require a 50% down payment prior to scheduling, payments can be made for the remaining balance.
  • Payments must be received every 30 days or account will be sent to collections.
  • Once account is sent to collections patient will be discontinued.
  • Once balance is paid in full, patient can be treated again; however a new patient form must be completed.


Patients can access the hardship application on our website, forms will be reviewed for a discount if you are self pay patient.  Hardship is granted based on financial need.  Proof of finances must be submitted along with the application or application will not be processed.


If patient receives a discount and then fails to make payments every 30 days on remaining balance, this discount will be revoked and the entire balance will be sent to collections.


All elective surgeries require the balance to be paid in full prior to scheduling.





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