This information is provided to inform you of our practice policy regarding financial obligations. If you have any questions or need clarification of any of these policies, please feel free to contact us.

Copays
The patient is expected to present an insurance card at each visit. All copayments and past balances are due and payable at the time of service. Our office accepts cash, checks, Visa, MasterCard and Discover Card.

Returned Checks
Checks returned from the bank for insufficient funds are subject to a $25.00 fee.

Unpaid Balances
Any unpaid balances on billings more than 30 days overdue are subject to a finance charge of 1.5% per month (18% annually).

Self-pay accounts
Self pay accounts are patients who are covered by insurance plans that the clinic does not participate in, patients without an insurance card on file, or who at the time of service do not meet the deductible.  It is expected that payment be made at time of service for all services including surgeries.

Nonparticipating insurance plans
The financial obligations of patients who are insured by carriers that this practice does not participate with are considered a self-pay account.  The insurance company will be billed as a nonassigned claim as a courtesy to the patient, with the patient paying the clinic the full amount due.

Allergy copays and balances
If you have a copay/coinsurance for your allergy shots or vials, we ask that you come prepared to pay that amount each week.

Office Policies
Patients requesting copies of their chart will be charged $.75 per page for the first 25 pages and $.50 per page for the remaining pages.  This charge must be paid at the time records are requested. Please allow 5-7 days for the processing of this request.

Patients calling our office to request a medication for an acute problem will be charged  $18.00 if you speak to the Nurse and/or a prescription is called to the pharmacy.  This payment is due at the time of the phone encounter.  This modest fee is less than most specialist copays. However, if you prefer to be seen in our office, we will make every effort to accommodate you.

Our office makes every effort to contact patients to remind them of their appointments, therefore we find it necessary to charge a minimum $25.00 no-show fee.

Policy updated 7/15/2015