Insurance and Financial Policy

Insurance Policy

We file most major insurance companies.

Please contact your insurance carrier to verify if we participate in your group plan. It is the member’s responsibility to verify we have correct insurance on file.

Financial Policy

Professional fees are due at the time service is rendered. This includes co-pays and any payment for non-covered services. There is a $30.00 fee for all returned checks. If more than 3 appointments are missed without notification, the practice reserves the right to dismiss the patient.

Please notify our office manager immediately if you need to make special financial arrangements for your payment of an account. Accounts delinquent for more than 90 days may be sent to our attorney for collection, and any costs incurred thereby will be the responsibility of the patient (parent of responsible party). If your account is turned over for collection, we may choose to no longer continue to provide medical care for your child.

Please notify us immediately if your insurance has changed, so that we may make certain your claims are sent to the correct company.

Divorced Parents:
In keeping with our policy, the person who brings the patient for his/her appointments are responsible for payment/copayment at the time of service. We will provide documentation of charges to either parent upon receipt of written authorization.

Form Fees:

  • Blue Slip $3
  • Sports Physical $5
  • Day Care $5
  • FMLA $15
  • Other $5

Credit Card on File Policy:
We require all parents to leave a credit card number on file with our office. The card number will not be stored on our computer servers, rather encrypted off-site at Instamed’s Secure Data Centers.  You can be assured your information is secure.  The card will be used as a convenient solution to paying your account balance. The card will be charged when the insurance company returns patient responsibility.