Office Policies
 

Patient Responsibility: We recommend you become familiar with your insurance benefits and confirm our participation with your plan. Most misunderstandings about insurance can be avoided if you understand what your policy covers. Please contact your insurance company with any questions you may have regarding your coverage.

 

Proof of Insurance: All patients must complete our patient information form before seeing the doctor. We must obtain a copy of your valid government issued identification and a current, valid insurance card. Please bring these items with you to each visit. Payment in full is required if we are unable to verify your current insurance information.

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Co-payments due at the time of service: Co-payment will be collected per your insurance policy. 

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Self-pay (for patients without insurance coverage): A $150 will be charged for an initial visit, and $100 will be charged for a follow up visit. 

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Nonpayment & Returned Checks: Unpaid accounts will be referred to an outside collection agency and could result in dismissal from the practice. 

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Annual check-up: During the annual check-up when other medical issues are addressed or managed, an additional sick visit may be charged in addition to annual visit. This may incur copayment depending on the insurance plans.

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No shows: Please notify us 24 hours in advance by phone or secure portal if you must cancel or change your appointment time. Failure to do so will result in $25. A third no show may result in dismissal from the practice.

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Insurance Carriers Requiring Referral: If you are referred to a specialist and your insurance carrier requires a referral number, our office must have at least a 48-hour notice in order to complete that referral.

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Form completion: All forms requiring medical review and physician signature – including FMLA, disability or other paperwork – will be subject to an administrative fee of $30.