Form – Financial Policy

Financial Policy

  • Thank you for choosing Okezie Pediatrics. We are committed to provide quality care to every child in your family in a courteous and professional manner. Please understand that payment of your bill is considered a part of your treatment. The following is a statement of our Financial Policy which we require you to read and sign prior to any treatment.

    Filing your insurance is a courtesy to our patients - Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. Therefore, you are responsible in making sure our office has updated insurance and personal information. You are responsible for making sure your insurance company pays and pays in a timely manner. If we participate with your insurance company, all co-pays and deductibles are due at the time of service. You are responsible in making sure that our office has all current insurance information at each visit. If your coverage changes to or is a plan where we are not participating providers, payment in full will be due at the time of service.

    If you have a balance - you will receive a statement each month letting you know the status of your account. Please be aware that some, and perhaps all, of the services provided may be non-covered services and not considered reasonable and necessary under your medical insurance. An account can only stay unpaid for 90 days and then it is turned over to a collection agency. The cost of the collection agency, which may vary, will be added to your total bill. At this point we will not be able to keep you as a patient and you will be asked to find medical care elsewhere.

    Usual and Customary Rates - Our practice is committed to providing the best treatment for our patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates.

    Missed Appointments - Unless canceled, at least 24 hours in advance, our policy is to charge for missed appointments at the rate of $25. Three or more no-show appointments may results in being discharged from the practice.

    Returned Check Fee - A$35 fee will be charged for any checks returned. If your returned check is not taken care when agree upon, your check will be sent to the District Attorney’s office, Check Buster Division. At that time you will be required to pay any/all fees accessed by that office and you would not permitted to write any checks to our office in the future. You will only be allowed to pay by cash or credit card.

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