In order to establish optimal relations with our patients and avoid misunderstanding and confusion regarding our payment policies, our staff is trained to consistently inform you of the financial payment policies of this office. Payment is required for all services at the time they are rendered unless you are in a prepaid plain in which we participate. WE DO NOT BILL PATIENTS. Payment for cosmetic products will not be billed under any circumstances.
As a courtesy to you, we will file to a participating insurance company for services our medical providers rendered today. Once payment is received is received we will adjust certain balances according to our contracts with your insurance carrier. If we do not have a contract with your insurance carrier, you will be responsible for payment at the time of service. Should we receive payment from your insurance company, you will be refunded in a timely manner. You are considered a cash patient until you bring in completed forms, and this office qualifies and accepts your coverage.
For those patients, applicable co-payments and deductibles will be collected at the time of visit. WE DO NOT BILL PATIENTS FOR DEDUCTIBLES OR CO-PAYS. We accept payment in the form of cash, check, or credit card. In the event of hospitalization or major procedures, our office may file a with the appropriate insurance. However, before such claims are filed, coverage will be verified and you will be asked to pay any remaining deductible, non-covered services and co-payments. In the event that your check is returned a $40.00 fee will be added to your account. Your initial signifies your understanding and willingness to comply with this policy.