FINANCIAL POLICY

CASH PATIENTS
FULL PAYMENT IS  DUE WHEN SERVICES ARE RENDERED.

WE PREFER CASH AND CHECK PAYMENTS.

VISA, MASTERCARD, DISCOVER AND AMERICAN EXPRESS payments are excepted.

CANCELLATION POLICY

WE ASK FOR 24 HOURS NOTICE TO AVOID A $50.00 FEE. 

INSURANCE PATIENTS
DEDUCTIBLES AND YOUR CO-PAYMENTS ARE DUE AT TIME OF SERVICE. 
WHEN WE ARE PROVIDED WITH YOUR INSURANCE INFORMATION, WE WILL SUBMIT THE CHARGES TO YOUR INSURANCE COMPANY. IF YOUR INSURANCE HAS NOT PAID WITHIN 90 DAYS, THE BALANCE BECOMES PATIENTS RESPONSIBILITY.
WE FILE INSURANCE CLAIMS AS A COURTESY TO OUR PATIENTS. WE WILL NOT BECOME INVOLVED IN DISPUTES BETWEEN YOU AND YOUR INSURANCE COMPANY REGARDING DEDUCTIBLES, CO-PAYMENTS, ETC., OTHER THAN TO SUPPLY ANY ADDITIONAL INFORMATION THEY MIGHT REQUEST. WE ESTIMATE THE PATIENTS CO-PAYMENTS. IT IS NOT A GUARANTEE OF PAYMENT. YOU ARE RESPONSIBLE FOR THE TIMELY PAYMENT OF YOUR ACCOUNT. IN THE EVENT NO BENEFITS ARE PAID, THE BALANCE IS THE SOLE RESPONSIBILITY OF THE PATIENT.

SHOULD THIS ACCOUNT BECOME PAST DUE, I AGREE TO PAY ANY FINANCE CHARGES OR LEGAL FEES NECESSARY TO COLLECT ON THIS ACCOUNT. 

THANK YOU FOR UNDERSTANDING OUR FINANCIAL POLICY. PLEASE LET US KNOW IF YOU HAVE ANY QUESTIONS OR CONCERNS.