- Full payment is expected at the time of services as well as any past due balances.
- Payment is due regardless of who brings the child in for the service.
- Grandparents, aunts, caregivers, etc.
- For families in which parents are separated and/or divorced, the parent bringing the child to the appointment is authorizing treatment and is therefore, the parent responsible for payment on the date of service. If there is a divorce decree requiring the other parent to pay a portion or all the treatment costs incurred, it is the responsibility of the authorizing parent to collect from the other parent. We can provide a copy of the claim or receipt of charges to the authorizing parent at each visit upon request to assist in the collection of fees from the other parent.
- Insurance must be presented and active in order to utilize your benefits. If Insurance cannot be determined as active, the patient will be considered self-pay.
- Self-Pay patients
- Visits are provided at a discounted rate
- Payment is collected at time of service.
- Your insurance determines if you have a co-pay, deductible and/or co- insurance.
- Insurance co-payments are due at each visit. Please note that we are required by the insurance company to collect payment. If your insurance plan has a deductible that has not been met, you are required to pay for services provided. VERIFICATION OF INSURANCE IS NOT A GUARANTEE OF PAYMENT! You are responsible for all services provided to your child/children.
- Any account balances carried over 90 days will be subject to outside collections.
- Forms Fee: the following family membership fees will be assessed annually as authorized by you. The annual administrative forms completion fees will be: 1 Child=$30, 2 Children=$55, 3 Children=$70, 4+ Children=$85.
**NO SHOW AND CANCELLATION FEES WILL BE ASSESSED WITHOUT 24 HOUR NOTICE PRIOR TO APPOINTMENT TIME.
$50.00 FEE APPLIES FOR WELL/ADHD/MED-CHECK/TELEHEALTH APPOINTMENT
$30.00 FEE APPLIES FOR SICK/NURSE/FLU APPOINTMENT