• All patients should provide accurate and complete personal and insurance information prior to being seen by the doctor. This will require that you fill out forms and provide a copy of your child’s insurance card before being seen. We advise that you bring a copy of the card with you at each visit. You may also be asked to periodically fill out a new information sheet so that our record of you stays current. Please voluntarily provide this information if there has been a change in the address or phone numbers since your last visit with us.

You can download and fill out the following form as (pdf file) prior to your visit to the office.

• All applicable co-pays are due at the time of your visit. Prior personal balances should be paid in full or have payment arrangements appropriately secured with the office manager prior to being seen by the doctor.
• Discount available for uninsured patients who's balance is paid in full at the time of visit.
• We accept cash, checks or credit cards (Visa, MC, Discover) for payment.

Insurance plans
We participate in many insurance plans. For some insurance plans we accept assignments of benefits, but in all cases we require that the guarantor (the person responsible for paying the bill) be personally responsible for paying whatever the insurance plan does not cover. Every insurance plan offered through employers varies in what it covers and under what conditions. We strongly recommend that you be familiar with your own plan benefits and the potential costs that might be incurred.  Even though your plan might be a major plan, the details of coverage negotiated by your company for coverage may be very different from another company’s plan. Also, companies frequently renegotiate their contracts with the insurance plans and change their plan benefits. Please make sure that you familiarize yourself with these changes if and when they do occur. It is our policy not to become involved in disputes between you and your insurance company about payments for services that we have provided, other than to provide the insurance company with factual information as necessary. Some insurance plans require that certain services be approved before they are provided (precertification). We are happy to do so if we are made aware that this is necessary.

Missed appointments
All appointment cancellations need to be at least 24 hrs in advance. If you miss a scheduled appointment without adequate notice to our front office staff, we reserve the right to charge a no-show fee of $20 per appointment missed.

Refunds
All overpayments will be refunded to the responsible party within 30 days, upon request.