Please note that if you are more than 15 minutes late for an appointment, you may be asked to reschedule. If you are unable to keep an appointment, advanced 24 hour notification is required. Two missed appointments could cause termination of your medical care at our office, so please call to cancel appointments prior to the visit to avoid this. We certainly appreciate you as a patient and respect your time, and these policies are to reflect that.

Thank you for choosing our practice as your healthcare provider. Your understanding of our financial policy is important to our professional relationship. Payment of your bill is considered part of your treatment. In an effort to provide you with the best possible care and minimize healthcare costs, we have adopted the following policies:

At each Visit our staff will request you to:

• Verify Your Personal Contact Information

• Present Current Copy of Your Insurance Card

• Provide Payment for Your Present Visit

Co-payments and outstanding balances are due at time of service. Please have your current insurance information with you at the time of your appointment.

If you have a question about your insurance, we will be happy to assist you. Specific coverage issues however, should be directed to your insurance company’s member service department as indicated on your insurance card. Not all services are a covered benefit in all policies. It is very important that you understand and confirm the provisions of your individual policy.

Patents without insurance may be afforded an adjusted fee if payment is made on the day of your appointment. You will be given these policies should your care warrant.

Please note that we do not accept Medicaid, Molina or Caresource insurance. If your insurance changes to one of these plans, please let the office know, and we will be happy to offer suggestions for practices that do accept these insurance plans and facilitate the transfer of your care.

We are happy to fill out FMLA and disability paperwork for maternity leave, surgical leave, or other medical leave. We ask that you leave the paperwork at the front desk. Please allow us one week to complete the paperwork. There is a $15 fee for completing the paperwork. Thank you.

Most insurance companies pay for one annual in a 12-month period. Check with your insurance company prior to your appointment to see if your insurance company requires a co-payment on yearly well woman visits. Patients that are seen for an annual exam and require additional treatments for illnesses or problems will be charged separately for each service rendered that day.

When your surgery is scheduled we will check with your insurance company for coverage on the procedure you are having done. We will estimate how much your surgery will cost and what your responsibility will be. Checking your benefits does not guarantee payment. The patient is ultimately responsible for payment. If your insurance company does not pay within a reasonable time, you will be billed for services. (Please note that hospital charges and services provided by other hospital related providers will be billed separately from our services, contact you insurance provider to determine specific coverage and benefits).

After your first OB visit, we will contact your insurance company and verify your benefits. Routine office visits are included with the delivery. Ultrasounds, Non stress tests, Lab, Facility Fees, and non pregnancy related office visits are billed separately and will require separate co payments, deductibles and/or co insurance amounts. We will estimate how much you will owe for the delivery only. This amount is expected to be paid by week 40 of your pregnancy. You may pay it all at once, or make payments per a payment agreement and schedule we will provide you. Any amounts for non included services will be billed to you separately. We will reimburse you for any overpayment that we may have received within 30 days of receipt of payment from your insurance company.