OUR COMMITMENT

 

We understand the cost of insurance premiums and we are committed to helping you receive your full benefits for the services you receive in our office.

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We will verify your current insurance coverage at the time of your appointment.

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We will submit insurance claims for you to all commercial payers and government plans.

 

We will provide you with information to file secondary insurances for reimbursement to you.

 

YOUR COMMITMENT

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You are willing to provide us with your insurance card and photo ID at each visit. This provides us with the information needed to file your medical claims. 

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You are prepared to pay your co-payments and co-insurance at the time of service. We accept cash, personal checks, and Visa/MasterCard debit and credit cards.

 

You are allowed to store a credit card on file. We do not store credit card numbers in our office, but use a secure link to access the information when we need to process a charge. This allows us to quickly process your co-pays and balances without having to hand us your credit card at every visit.

 

You understand we are a business and therefore must recoup service fees in the event a personal check is returned unpaid from your bank. A returned check fee of $30 will be charged.  Late co-pays are subject to an additional $30 service fee.

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You are committed to helping us receive reimbursement for the services rendered to your child. If necessary, you are willing to contact your insurance company or Human Resources Department to assist with getting a claim paid. 

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Please understand that insurance policies belong to you and not us. Therefore you may be asked to submit payment while you work with your insurance company for reimbursement. 

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COMBINED COMMITMENT

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We understand illnesses arise and you may not be financially prepared at that time. We are committed to caring for your child and know you are committed to paying for those services. 

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In the event you are unable to pay your account balance at the time of treatment ask to speak with an Insurance staff member; we will review payment options for automatic monthly payments to be charged to your credit card. You will receive an email reminder before the payment is processed and an email receipt of payment until the balance is paid in full.

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