Self-Pay: If you do not have insurance coverage and elect to pay out-of-pocket for services provided by the Practice, you are responsible for payment in full for all services at the time services are rendered.
Outside Pathology, Lab Fees: Pathology and lab samples sent outside of our office are billed independently of the Practice. You may receive a bill from the outside lab and will be solely responsible for payment to the lab company.
Out of State Insurance: If you present to the Practice an out-of-state HMO/PPO insurance card, the Practice must verify your benefits for out-of-state or out-of-network benefits. You may be required, in the sole discretion of the Practice, to make payment in full, or pay any co-payment, co-insurance, or deductible. Any sums paid by you for services later reimbursed by the out-of-state insurance company shall be repaid to you by the Practice.
“No Show” and Late Cancellation Policy: In the event that you cannot keep a scheduled appointment, you are requested to notify the Practice at least forty-eight (48) hours in advance. If you (i) do not notify the Practice forty-eight (48) hours in advance of any missed or cancelled appointment, (ii) arrive more than fifteen (15) minutes later than your scheduled appointment time, or (iii) do not keep your appointment without cancelling in accordance with these policies, you will incur a cancellation fee of $125.00 per missed appointment. Patients enrolled in the Medicaid program are not subject to the cancellation fee. You agree to provide us with your credit card information, which we will keep on file at the Practice. You authorize us to charge your credit card in the event you incur any fees pursuant to this “No Show” and Late Cancellation Policy, and you will notify us should your credit card information change at any time.
Collection: All outstanding balances owed by you shall be paid within thirty (30) days of receipt of a bill by the Practice. Any balances greater than ninety (90) days in arrears will be turned over to a collection agency if not addressed.