A parent or legal guardian must accompany a minor patient unless prior written authorization is given to this office. The adult accompanying the minor is required to pay in accordance with our policies. We do not accept third party assignment, nor do we recognize or enforce the terms of divorce decrees.
Payment is expected at each visit, be it a deductible, co-payment, percentage or payment in full for services rendered. We now offer our patients with high deductible plans, 2 options.
1. Complete and sign a secure credit card payment form to have on file for processing patient balances. We will submit your claim to the insurance company and process your portion of the bill once we receive the EOB (Explanation of Benefits). A receipt will be mailed or secure emailed to you.
2. Pay your portion of the visit at the time of service.
Any accounts with outstanding balances greater than 60-days from the date of service will be subject to collection. We realize at times that there may be a financial hardship. In order to keep your account in good standing, it is imperative to contact our billing department to make a financial arrangement.
There is a $30.00 charge for all returned checks. NSF checks must be redeemed with certified funds (cashier’s check, money order, certified check or cash).
Our practice is happy to answer any billing questions or concerns you may have. You can reach our Patient Representative, Carrie G at (623)-878-2800, extension 116 or by emailing her at firstname.lastname@example.org.
Due to all various insurance plans now in effect in the market place, it has become a very complicated process to become familiar with each plan. We therefore are requiring your cooperation so that we may better serve you and give you the proper healthcare you deserve without spending an exorbitant amount of time obtaining benefit information from your insurance company. It is your responsibility to know all of the information required by your insurance plan to avoid unexpected out of pocket expenses associated with cost sharing or non covered services. Examples being: after-hours charges, well visit coverage, immunizations, in-house testing, contracted laboratory, radiology, durable medical equipment and sick visit coverage.
We require you to notify the scheduler when you make your appointment of any of the following: change of insurance, address, telephone numbers and emergency contacts. By doing so, this will eliminate unnecessary delays in your child’s care.
“Walk-in” and “add-on” appointments place the physician and staff in a difficult and uncomfortable position. We want to take care of your child’s illness; however, it is unfair to our patients who have scheduled an appointment to ask them to wait while someone without a prescheduled appointment is seen. Please call to schedule your appointment. If you feel your child cannot wait to be seen, ask to speak to the triage nurse.
If you are unable to arrive for your appointment on time, please call to inform the staff. They will review the schedule to determine if the appointment will need to be rescheduled or work you in behind the scheduled appointments.
Please be aware, failure to cancel your child’s appointment hinders another patient’s ability to be seen by our physicians. Therefore, we require a courtesy call 24 hours prior to the patient’s scheduled appointment. A $25.00 charge will be applied for all “No Show” appointments. Repeated “No Show” appointments may be subject to discharge from the practice.
3. Pets in the Office:
Our practice cares for children with many types of illnesses and allergies, some of whom have severe allergic reactions to animals. In order to protect our highly allergic patients, we cannot allow pets in the building with the exception of certified service animals. Thank you for your understanding.
We are compassionate to the difficulties split homes and divorce can cause and will try to help any way we can. However, we cannot take sides or get in the middle of a difficult situation. We will honor whatever legal arrangement your family has but ask that you refrain from putting us in the middle of quarrels. Thank you for your understanding.
5. Masks and COVID-19:
Our office has been following CDC (Center for Disease Control) and AAP (American Academy of Pediatrics) guidelines in regards to masks, social distancing, and infectious disease control recommendations throughout the COVID-19 pandemic. We will continue to follow the strictest guidelines to ensure that we keep our patients, their families, and our staff safe. We ask that you continue to wear your face mask when you come to our office and leave it on the entire visit.
We understand that many of us are vaccinated, and we also understand that we are all very weary of wearing masks. Our goal is to continue to protect those patients who are at the high risk of poor outcome if they get COVID-19 such as our newborns, premature babies, and those with immunocompromised systems. We ask that you respect our policies and continue to wear your masks at all times in our office. Thank you.