Late / no show and outstanding balances policy

Effective 3/16/2022

Late / No Show Policy

In an effort to provide the best care for all of our patients, we have implemented new policies regarding late arrivals and no shows. If you are unable to make your scheduled appointment, please notify the office at least 24 hours before your scheduled appointment. We understand that things happen, but please let us know as soon as possible. If you arrive more than 10 minutes late for your appointment, you will be asked to reschedule depending on appointment availability that day or may incur a wait if the physician has openings in their schedule.

For No Shows and last-minute cancellations (less than 24-hour notice), a $50 dollar no show fee/cancellation may be added to your account, which must be paid in full before you can be seen in the office again. This fee will be applied again for all subsequent no shows as well. After the third no show, we reserve the right to discontinue services and care.

Deductible / Deposit Policy (please read)

If you have more than $250 remaining on your yearly deductible, we will require a $75 deposit to be paid at the time of your visit. This deposit will be applied to your anticipated bill due to the outstanding deductible amount. Any amount overpaid by the patient will be refunded to the patient via check once the claim is fully processed by your insurance company.

Outstanding Balances

Any balances that are 30 days or more overdue must be paid in full before you can be seen by the doctors in the office. Any balances that are 30 days or longer overdue are subject to being sent to a collection agency. If your account is sent to a collection agency, we reserve the right to discontinue services and care.

By signing this form below, I have reviewed and understand the late/no show and the outstanding balances policies outlined above.