You may also receive a separate bill for services performed outside our office, such as labs, imaging, etc. Questions regarding those charges should be directed to the appropriate external service provider.
We accept cash, checks, money orders, most bank cards, and most major credit cards. We reserve the right to process your payment electronically based on information you provide to us. Returned checks must be resolved before any future appointments can be scheduled. We reserve the right to refuse any personal check and to require another form of payment at our sole discretion.
Minor Aged Patients
Parents or guardians are responsible for payment of any fees not covered by insurance for a minor. For unaccompanied minors, treatment will be denied unless we have received the proper paperwork.
Credit Balances and Small Balance Write Offs
Occasionally an overpayment is made and a refund is due to the patient. Unless you object, credit balances will be applied to any existing or new balances on your account or held to cover future services already scheduled. If after six (6) months the credit still exists and there are no future services scheduled, all unapplied credit balances over $10.00 will be refunded to the patient. If a refund is due to insurance, this will not change the amount due from the patient for “patient responsible” balances. Similarly, we will hold balances under $10.00 that are due to the practice on account for this same 6 month period and if no future services are scheduled we will write that amount off under our small balance write off policy. The small balance policy does not pertain to any government payer or patient covered by a government program.
Account Delinquency and Credit Reporting
Our office makes every reasonable effort to collect payment from insurance companies and patients. Once these efforts are exhausted, we may report unsatisfied accounts to a collection agency of our choice for payment and credit reporting. Before an account is sent to collections, any applied but unearned discounts may be reversed. Additional expenses, usually 35% of the amount sent to collections, are incurred and subsequently added to the patient’s balance. Unresolved accounts may be referred to court mediation. If you have an account that is referred to our external collection agency your credit may be negatively affected.