NO-SHOW / LATE CANCELATION POLICY

 The following policy has been established to help us serve you better. It is necessary for us to make appointments in order to see our patients as efficiently as possible. No-shows and late cancelations cause problems that go beyond any financial impact on our practice. When an appointment is made, it takes an available time slot away from another patient in need of medical care. Not canceling an appointment in a timely fashion is unfair to other patients, some of whom may be quite ill and may unnecessarily delay the delivery of health care. For these reasons we have adopted the following No-Show/Late Cancelation Policy.

 A no-show is defined as missing a scheduled appointment without calling us in advance to cancel the appointment. A late cancelation is defined as failing to cancel or reschedule a scheduled appointment 24 hours before the scheduled appointment. We request that if you need to cancel or reschedule your appointment, you must contact our office 24 hours prior to your scheduled appointment so that we may offer the appointment to another patient in need of medical attention.

 You will be charged a $35.00 fee for a no-show/late cancelation. This charge will apply to each appointment that a late cancelation or no show occurs. This fee is subject to change. The current no-show/late cancelation fee will be posted in the office and on our website. This office will not submit this charge to your insurance carrier or Medicare, as applicable. These fees are your financial responsibility, and they must be made prior to making any new appointment. A patient who no-shows three times within a 12-month period, regardless of whether it is in the same calendar year, is subject to dismissal from the practice.

Finally, we understand that circumstances beyond your control may arise, where adequate notice is not possible. These limited situations will be considered on a case-by-case basis.

 Please understand that the intent of this policy is to aid us in offering a high standard of care to our patients and that this policy is in place to help us achieve this goal. We pledge to do our part to keep our schedule moving as efficiently as we possibly can. We value you as a patient and appreciate your understanding and cooperation.

ADDITIONAL POLICIES

• All payments are due at the time of service.

• There will be a $35 fee for all returned checks.

• Due to the constant change in insurances, it is no longer an easy job to interpret policies. Although we try to stay aware of the changes it is not always possible. It is your responsibility to know your insurance coverage. Please do not be angry with us if your insurance company does not cover your visits. All insurances have exclusions, deductibles, and copays. Please remember your insurance is between you and your insurance company, not between our office and your insurance company.

• Referrals are the patient’s responsibility.

• ALL WORKERS COMP, DISABILITY, AND AUTO INSURANCE PAPERWORK MUST BE PAID PRIOR TO FILLING OUT THE FORM AND FAXING OR PICKING UP. COST PER PAGE IS $10

A copy of our HIPAA Notice of Privacy Practices and Quality Measures information are available to read and/or print. We are also happy to provide you with paper copies of all forms when you arrive for your appointment.