Thank you for allowing us to take part in your healthcare. To help manage the cost of your healthcare, we have developed a fair payment policy so that you can receive comprehensive care and minimize the stress associated with the financial burden of good care.
If you have a past due balance or incur substantial new charges that make it difficult for payment at the time of service, the office staff has the capacity to allow you to make a payment plan to address those amounts. We do ask for reasons of fairness, that all patients where this applies make the plan before they incur additional charges. The payment plan requires as little as $10 at a time, but does require that payment is automated. Be assured, all private information is managed by a national 3rd party vendor who follows federal privacy regulations.
If you have insurance, we will bill it for the services we provide, however, please realize, insurance benefits, is a contract between you and/or your employer and your insurance carrier. If there are services within certain standards that we provide, even if the insurance does not pay, they are your responsibility. It is also your responsibility to advise us of any updates or changes to your insurance. Most insurances will not pay if a claim is filed after 60 days and therefore it would be your responsibility.
Co-pays are due at the time of service. We may send periodic statements with any balances after your insurance company has paid. If you have any questions about charges on your statement, please contact the Billing Department immediately. The balance on your account is due immediately once responsibility has been determined, whether, by the EOB (Explanation of Benefits) from your insurance company or by statement.
Payment Plan Options
Past Due Balance | BI – Weekly | Monthly |
Up to $50 | $10 | $15 |
51-100 | $15 | $25 |
101-150 | $20 | $35 |
151-200 | $25 | $45 |
201-250 | $30 | $55 |
251-300 | $35 | $65 |
301-400 | $40 | $75 |
401-500 | $45 | $85 |
501-600 | $50 | $95 |
601-700 | $55 | $105 |
701-800 | $60 | $115 |
801-900 | $65 | $125 |
901-1000 | $70 | $135 |
1001-1100 | $75 | $145 |
1101-1200 | $80 | $155 |
1201-1300 | $85 | $165 |
1301-1400 | $90 | $175 |
1401-1500 | $95 | $185 |
1501-1600 | $100 | $195 |
1601-1700 | $105 | $205 |
1701-1800 | $110 | $215 |
1801-1900 | $115 | $225 |
1901-2000 | $120 | $235 |
2001-2100 | $125 | $245 |
2101-2200 | $130 | $255 |
2201-2300 | $135 | $265 |
2301-2400 | $140 | $275 |
2401-2500 | $145 | $285 |
2501-2600 | $150 | $295 |
2601-2700 | $155 | $305 |
2701-2800 | $160 | $315 |
2801-2900 | $165 | $325 |
2901-3000 | $170 | $335 |