Patient Policies

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PAYMENT AGREEMENT AND FINANCIAL POLICY


Upon Check-in, we will collect your deductible, co-pay, uncovered services, or percent of your responsibility.


​​Please be prepared to pay before you are seen by the doctor. 

Please be thorough with your insurance information if you expect us to file for you. Bring your card with you and a driver’s license. Without these, we will be unable to see you!

CANCELLATION AND NO SHOW FEES/NOTICE: Failure to cancel an appointment within 24 hours will result in a $50.00 no show fee that will be charged directly to you.

FOR PATIENTS WITH INSURANCE: As a courtesy, we will file your insurance. We will bill contracted insurance carriers if proper and correct information is provided. As some time limits are dictated to us, insurance information must fill out corrected initially. If incorrect information is provided, then the patient will be responsible for payment in full. It is your responsibility to make sure we receive prompt payment from them. It is useful to maintain frequent contact with your insurance carrier to make sure they are paying as they should. Any Copayments, Coinsurance, and/or deductibles are due at the time of service.

TO ALL MEDICARE PATIENTS: We will continue to participate as Medicare providers. We will bill Medicare as well as secondary insurance, but if payment is not received from your secondary insurance within 45 days you will be notified and must pay our office the balance due. You must then contact your secondary insurance to pay you for the balance you paid our office. If no secondary insurance information is provided, patients will be responsible for 20% of the Medicare allowable charge at the time of service. Any Copayments, Coinsurance, and/or deductibles are due at the time of service.

BALANCES: All due balances should be paid prior to your next appointment. Accounts that have balances more than 90 days past due may possibly be turned over to a collection agency unless previous arrangements have been made.

COLLECTION PROCEDURES: Collection procedures are started after 3 invoices have been sent to the address in file and personal contact has been attempted. It is requested that you keep your information updated should there be any changes in addresses. In the unfortunate event your account should be sent to collection and you wish to return to the practice (subject to practice discretion), a surcharge of 50% will be added to balance administrative fees. These fess can only be collected through cash or check payments.

If your insurance denies payment on your account you will be asked to pay by check, cash, or charge. If you do not pay in a timely fashion, your account may be subject to a monthly finance charge and turned over to collections. If you do not agree with the denial it is your responsibility to pay services and take it up with your insurance.

SELF PAY PATIENTS: This category includes those people with no insurance and patients who have an indemnity plan and wish to file their own insurance. Payment for medical services is expected on the day the services are rendered. We accept cash, Visa, MasterCard, checks, and money orders. If you will not be able to pay for our services in full, you must contact the office to make a payment agreement before coming to see the doctor.

If your insurance is out of state (except PPO insurance), you must pay for your visit at the time of service. 95% of out of state insurance companies pay the patient and will not pay us directly (even if they tell you they will).