Appointments: 602-978-2500
5940 W. Union Hills Dr., Suite D-100,
Glendale, AZ 85308

Payment Policies

Payment for Services

Charges for services are described in our fee schedule which can be obtained upon request. For your convenience we accept Visa, MasterCard, Discover Card, American Express and cash. You can also log on to the patient portal & pay any outstanding balance with a credit card.

We no longer accept checks. If for some reason a check is sent in and returned by the bank we will charge a $25.00 fee. If you have a returned check then you will be required to pay by cash, money order, or credit card for all future services.

It is important that you become familiar with the provisions of your insurance coverage. Coverage varies with all insurance plans and cannot be guaranteed. Some plans only cover services rendered at certain hospitals, labs and outpatient facilities.

It is your responsibility to know if your insurance covers well exams, immunizations and what amount they cover. Many times they provide limited benefits on these services. If our office has to call your insurance company regarding benefits we cannot guarantee the benefits that are stated to our staff. You will be responsible for all non-covered services rendered at our office at the time of the service.

More information on insurance and claims.

Visit our Patient Portal to obtain your shot and medical records for no charge. For your convenience, we can also print these records for you for a small fee.



Copays, Deductibles, coinsurance & Balances

Are due at the time of service. There will be a $10.00 fee for any copay/coinsurance not paid by the next day of service by 5:00pm.

Release of Records

Your 1st copy of your child's medical records are given to you and picked up at no cost, thereafter a $25.00 fee will apply. There will be no charge for records requested directly by your insurance company or by a specialist that we have requested to see your child. Records will not be faxed. You can pick up your records or have them mailed .  If you are the patient and over the age of 18 you must have your driver's license on file and complete the request for records yourself.

There is a $10.00 mailing fee for any record.

FMLA & Medical Forms

There is $10.00 fee for each child or each form that needs to be completed. Please make sure to have the employee requesting FMLA sign the appropriate pages so that we may forward it to your work via fax. Please make sure to bring any physical/sports forms at the time of your exam. There is no charge if completed within one month of the exam date, thereafter there is a $10.00 form fee.  A request is not a guarantee a form can be completed.  The doctor must review the chart and make sure all medical criteria is met.

No Shows

A $25.00 fee will be charged when a scheduled appointment is not canceled or re-scheduled ONE HOUR prior to the appointment time.

** All of the above records will be prepared within 7-10 days upon receipt or payment. Records for patients that have not been to our office in over 3 years may take an additional 10 days to process. 

Update Patient Information

You are required to fill out complete paperwork once a year, or whenever there is a change in insurance or address.

Questions

If you have any questions regarding your account, please call our Billing Department at 602-489-5830, Monday - Friday, 8 am - 4 pm
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