VACCINE POLICY - please review COMPLETE policy in our office or download policy.
Our policy is written to emphasize the importance of vaccinating children. We recognize that the choice may be a very emotional one for some parents. We will do everything we can to provide education and information that vaccinating according to the schedule is the appropriate thing to do. We follow the recommendations of the AAP and CDC. If despite our recommendations, you feel you cannot follow the AAP and CDC recommendations for these vaccines, we will ask you to find another health care provider who shares your views.
We also strongly believe in continuity of care and not practicing fragmented care. We require your annual physicals to be performed at our office to receive the corresponding age-appropriate vaccines. If you choose to go to an urgent care center for your physical we will not be able to administer any vaccines due to the risks posed by the lack of an updated history and physical exam in our office.
FINANCIAL POLICY - please review COMPLETE policy in our office or download policy.
We are committed to providing you with the best possible care and we will gladly discuss our professional fees with you at any time. Your clear understanding of our Financial Policy is important to our professional relationship. Please ask if you have any questions about our fees, Financial Policy, or your responsibility in regards to your services.
YOUR PORTION OF THE BILL IS DUE AT THE TIME OF SERVICE. -Including: Co-Pays, Deductibles, Non-Covered Services, etc.
WE ACCEPT CASH, CHECKS, VISA, DISCOVER AND MASTERCARD - ASK ABOUT OUR SECURE CREDIT CARD ON FILE POLICY
If you do not pay at time of service there may be a billing fee assessed. Any insurance claim will only be submitted if we are furnished FULL insurance company information needed. Please be aware insurances mandate a time frame for filing insurance claims.
If we do not receive insurance information within 45 days of the date of service no claim will be filed and you will be responsible for payment.
Please verify with your employer or insurance company if we are participating with your specific plan BEFORE scheduling appointments.
We will not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, “usual and customary” charges, etc., other than to supply factual information as necessary. You will need to resolve these with your insurance.
YOU ARE RESPONSIBLE FOR THE TIMELY PAYMENT OF YOUR ACCOUNT.
Please be advised that you are initiating services to be rendered and ultimately you are financially responsible for all charges incurred whether paid by your insurance or not.
REFERRAL PROCESS POLICY - please review COMPLETE policy in our office or download policy.
Many insurance plans, especially capitated plans such as Aetna HMO, Keystone Health Plan Central, and Gateway have complicated rules regarding specialist visits and referrals. Even within the same insurance company, policies and procedures may vary from one employer to the next.
YOUR INSURANCE IS A CONTRACT BETWEEN YOU AND YOUR INSURANCE COMPANY. When you need to visit another doctor or facility, it is your responsibility to know your specific benefits. If you are unsure, you can get more information by calling the member services number on the back of your insurance card.
If your insurance plan does need referrals, our office policy requires a minimum of two (2) business days to process a routine referral. We recommend that you contact us as soon as you make an appointment with a specialist. We cannot “back date” a referral.
If you were already seen by a specialist without a referral, we will not be able to process one after the fact. If you call us on the way to the specialist, or while at their office for your visit, we will not be able to process your request in time for your scheduled visit. You may be asked to reschedule the appointment if the specialist cannot verify that you have a referral in the system. If you need to see a specialist for a follow-up appointment, please ask if you will need an additional referral or if the original referral included a certain number of follow-up visits within a defined period of time.
If you would like an “non-par” referral (to visit a specialist or facility that is out-of-network), we require 5 business days to handle such requests.
NO SHOW POLICY - please review COMPLETE policy in our office or download policy.
The relationship between doctor and patient is a two-way street. There are rights and responsibilities on both sides. When you make an appointment to see one of our doctors or our physician’s assistant, that time is set-aside just for you. We attempt to confirm appointments a day in advance but ultimately you are responsible to mark your calendar to assure you are available to keep the appointment.
We do understand there could be a circumstance when you are unable to arrive for appointments. However, if this becomes a pattern for your family’s appointments, there will be consequences involved. If you have missed an appointment in our office we ask you to be sure to keep future appointments or cancel them with a two-hour advanced notice to avoid being considered a “no show”.
Last minute cancellations still result in lost appointment times.
We do require a 2-hour notice to cancel appointments.
Less than 2-hour notice will result in a “no show” fee of $20.00 assessed to your account.
If you do not keep an expanded visit, such as a consultation or Complex check-up there will be a $50.00 fee for the lost visit.
If your family has had 3 no show appointments within a year, or an excessive amount compounding over the years, you may be asked to find another practice that better meets the needs of your schedule.
Policies & Misc. Forms: