PAYMENT & POLICIES
- Co-pay: Varies per individual plan; payable at each visit.
- Co-Insurance: Many plans require out-of-pocket payments in the form of a deductible or patient co-insurance. Until you satisfy your deductible or co-insurance amount, our charges are payable at the time of each visit.
- Missed co-pay: $10 each
- Missed Appointment: $50 - Well visit, $25 - Sick visit
- Late PE Missed Appointment: Full PE Charge
- School/Camp Form: $10 per form per patient or $20 for two or more forms per patient when submitted simultaneously.
- Allergy Protocol Form: $10 per form per patient or $20 for two or more forms per patient when submitted simultaneously.
- Returned check: $25 each
- Collection charge: Individual
- After-hours Surcharges: Services rendered outside of our standard business hours may be billed with surcharges. Surcharges may apply to walk-in hours, late physicals and weekend/holiday visits. If late physical appointments are missed, the full physical fee will be charged.
- Your statement is mailed once a month and indicates your balance. Payment is due within 15 days from receipt of the statement.
- We will bill any balance due to your account after your insurance company responds to our filing.
- A balance 30 days past due is subject to an 18% annual interest charge.
New Health Exchanges If you have insurance through a health exchange, we are not able to see you “in network” even if the plan is through an insurance company with which we do participate, such as a commercial plan with Anthem or Oxford. If you choose to continue under our care, you will be responsible to make all payments at the time of each visit. If applicable, we will provide a bill for you to submit to your insurance plan for reimbursement.