Cancellation of all appointments must be made within 24 hours of the appointment time. Failure to do so will result in a fee of $20 after your 3rd occurrence and is due on or before your next schedule appointment.
You will need to request in writing, and pay a reasonable copying fee for any medical records. The amount of the fee is dependent on the number of pages we need to copy. You authorized us to include all relevant information, including your payment history.
Monthly statement: If you have a balance on your account, you will receive a monthly statement, as well as phone calls. The monthly statement will show separately the previous balance, and new charges to the account, the finance charge, collection fee, if any and payments or credits applied to your account during each month.
Payments: Unless other arrangements are approved by us in writing, the balance on your statement is due and payable in full when the statement is issued. And is past due if not paid by the end of the month.
Required payments: Any copayments co insurance and deductibles required by insurance company must be paid at the TIME OF SERVICE!! (NO EXCEPTIONS) this is and insurance requirement!
Medicare: If Medicare is your primary and only insurance you are required to pay 20% at the time services are rendered.
Non Covered (Medicare / Medicaid): The patient will read and ABN this states the patient is responsible for any services not covered by Medicare / Medicaid.
Third Party Insurance: Third party insurances are not accepted.
Contracted insurances: We must follow your contracted insurance requirement.
Workers Compensation: We require written approval / authorization by your employer and/ or workers comp carrier.
Past Due Accounts: If your account becomes past due we will need to take the necessary steps to collect this debt. As far as payment arrangements there are accepted and we will accommodate you as much as possible.