Financial Policy

Overview

Payment for services is due at the time of your visit unless other arrangements have been made in advance with our billing office. We accept cash, check, and all major credit cards.

Patient Information & Forms

• All new patients must complete our patient information forms prior to being seen. Established patients must update their information on a yearly basis, or as information changes.
• Please notify the office 24 hours in advance if you are unable to keep your appointment.
• If your child has school, camp, or sport forms to be completed, please allow a 3–5 business day turnaround time.

Insurance

Our office participates with many managed care insurance companies. Should your insurance coverage be with one of these companies, we will bill your insurance company along the guidelines of our contract. Co-payments, co-insurances, deductibles, and non-covered services that have not been satisfied are the responsibility of the patient.

To ensure accuracy when billing your insurance company, we must have a current copy of your insurance card on file. If we are unable to verify your insurance benefits, you will be required to pay at the time of service. Your insurance is billed as a courtesy only, and all charges — including non-covered services, deductibles, and co-pays — are your responsibility.

We must be notified of any changes in your insurance coverage and have the insurance verified prior to seeing the doctor. If you do change insurance carriers, please call the office prior to coming in for your appointment, so we can have your insurance verified before your visit.

Copayments & Deductibles

• All insurance co-pays and percentages are due on the day of the visit. If not paid on the day of the visit, a $5.00 late fee will be added.
• You will be required to pay for office visits in full until your yearly deductible is met.

Uncovered Services & Annual Physicals

Before making an annual physical appointment, check with your insurance company. Not all plans cover annual healthy physicals, or hearing and vision screening. It is your responsibility to know your insurance plan benefits. If a service is not covered, you will be responsible for any balance not covered by insurance.

Newborns & Insurance Changes

New babies must be added to your insurance policy before any claims will be paid. Most insurance companies require that you do this within thirty (30) days after the baby is born. Please verify this requirement with your insurance company.

Statements & Collections

• Patient balances are billed immediately upon receipt of your insurance plan's explanation of benefits (EOB). Your remittance is due within 30 business days of your bill.
• If your insurance company has not responded within ninety (90) days from the date the claim was filed, you will be responsible for payment of the bill. In the event the insurance company pays after you have paid, you may request a refund.
• Any balance over 120 days will be forwarded to our collection agency.

Missed Appointments

Please notify the office 24 hours in advance if you are unable to keep your appointment.

Payment Difficulties

There are times when making a payment can be a financial hardship. Please advise our staff prior to your visit if you are in need of a special payment arrangement.

Returned Checks

All returned checks will be assessed a $30.00 returned check fee. After two returned checks, we will no longer accept personal checks on your account.

Questions About Billing

Our billing office is happy to discuss your account, set up a payment plan, or answer any questions. Call (814) 944-7383 or email phca5@yahoo.com.