Payment Policy

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. We charge a $25.00 fee for any returned checks if mailed in. If you have a returned check you will be required to pay by cash, money order, or credit card for any future payments.

It is your responsibility to know your policy and what is covered.  Many times they provide limited benefits information to our office.  Calling your insurance plan is not a guarantee of coverage and your cost may be more than what you are charged the day of the visit.  

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.

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.  Release of any medical information must be requested by either a biological parent, legal guardian or patient if over age of 18.

There is a $10.00 mailing fee for any record.

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. FMLA is based off of medical history and may not always be able to be completed.  Please make sure to ask prior if your child is eligible.

Please make sure to bring any physical/sports forms at the time of your exam. There is no charge to complete at the time of your childs physical exam or 30 days from date of exam.  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

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

We will send you a link from Phreesia for every appointment scheduled.  You are required to verify or update your informaton.  Please make sure to update your address or insurance change.  You will also be sent a permission to treat.  This form is for you to complete if you are requesting anyone other than parent/legal guardian to bring child in.

If you have any questions regarding your account, please call our Billing Department at 602-489-5830, Monday - Friday, 8 am - 5 pm.