PrimeTime Pediatrics/PrimeTime Urgent Care Registration
Thank you for choosing PrimeTime Pediatrics (PTP)/PrimeTime Urgent Care (PTUC) to care for you and your family today. Please understand that payment of your bill ensures the practice remains financially healthy and stable so that we may continue to provide care for future patients. If you have any questions regarding this financial policy, please do not hesitate to speak with management.
With the exception of Copays and Self pay which are due at the Time of Service, who is Financially Responsible for any bills that may occur due to deductibles, coinsurance, or balances that insurance may deem to be the patient's responsibility?
Please have your insurance card and drivers license ready when you arrive at our facility.
By submitting this form, I attest that the above information is accurate and truthful to the best of my ability. I acknowledge that some information may require additional explanation or verification. I will contact PrimeTime Urgent Care in a timely fashion if any of the above information requires change or modification. I acknowledge that I have been provided, and have reviewed, and understand the PrimeTime Financial Policy.
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