Co-pays and non-covered services (managed care patients).

Fees for service if private pay.

Additional fees for forms, missed co-pays, returned checks, missed appointments or collection charges.

Account statements showing private balances are mailed twice monthly. To avoid interest charges, payments are due within 15 days.

We must have a current and accurate insurance card on file at the time of each service. Otherwise, claims cannot be submitted to your carrier and fees will be charged to the guarantor.