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Office and Financial Policies

PLEASE READ OUR POLICIES CAREFULLY. WE ARE A FRAGRANCE FREE OFFICE. PLEASE DO NOT WEAR ANY SCENTS.

TO MY VALUED PATIENTS:
I am committed to providing you with the highest quality of patient care. The following is a statement of my financial policy. Your signature will be required prior to any treatment being rendered, stating that you have read this policy. It is the patient’s responsibility to inform staff of any changes in their demographics: insurance, address, or phone number.

FRAGRANCE FREE:
We have staff members and patients who are extremely sensitive to some fragrances. Please refrain from wearing perfumes, colognes, body sprays, and/or scented powders to your appointment.

USUAL AND CUSTOMARY RATES:
We endeavor to maintain costs of services comparable to what is customary for our area. We accept most major PPO insurance plans and have an agreement with Bakersfield Family Medical Center/Heritage Physician Network to see their HMO customers. Please check with us and your insurance carrier if you wish to establish care or want to change your insurance coverage.

WE NO LONGER ACCEPT CASH PATIENTS

INSURED PATIENTS:
You are responsible for providing us with your complete and current insurance information. If we are unable to verify or validate your insurance at the time of service, you will be considered a “Cash Patient” and be expected to pay in full. We will reimburse you in the event we receive payment from an insurance company.

NOTE: You are ultimately responsible for all costs regardless of what your insurance company determines are eligible.

OFFICE VISIT CO-PAYMENTS:
Flat fee co-payments are collected when you check-in. You are responsible for your co-payment or contracted portion of reimbursement at the time of service. We do not bill for co-payments. If you do not have your co-payment at the time of service your appointment will be rescheduled.    We accept cash, checks (with current id), VISA and MasterCard only.
For families with dual insurance coverage, a birthday rule applies. The birth date of the parent that falls first in the year becomes primary for dependents.

MINOR PATIENTS:
We treat patients ages 7 and up. Written parental consent is required by law if the minor is not accompanied by a qualifying parent or guardian.

MISSED APPOINTMENTS:
There is a $50 fee for same-day cancellations and missed appointments. If you are more than 10 minutes late to your scheduled appointment, we will try to fit you in, but you may be asked to reschedule. If you are unable to keep your scheduled appointment please notify our office staff at least 12 hours in advance. You may leave a message with our answering service when our office is closed. We understand that sometimes circumstances may prevent you from keeping your appointment. Frequent missed appointments or same day cancellations are not tolerated and you will be asked to find another physician.

FORM FEE:
There is a $30.00 fee payable in advance for each form that is to be signed or completed by the physician or office staff. Please complete your portion prior to your visit.

RETURNED CHECKS:
We take checks as a courtesy to our patients. When a check is returned from the bank for non-sufficient funds we will notify you immediately. Our return check fine is $30.00. If the balance has not been paid within 30 days from the date written it will be turned over to Commercial Trade Bureau, our collection agency and you will be asked to find another physician.

DELINQUENT ACCOUNTS:
Our office makes every attempt to collect on past due balances. Unpaid balances will be turned over to Commercial Trade Bureau, our collection agency. In addition to the balance you owe, Commercial Trade Bureau will assess interest on your past due balance and you will be asked to find another physician.

MEDICAL RECORD COPY FEE:
There is a $30.00 copy fee for each set of medical records requested. Copies of your medical records are available to you in paper or electronic format (USB thumb drive or CD). There is no charge for transferring records to another physician for continuation of care.

DON’T RUN OUT!
Avoid “I’m on my last pill” situations.

Allow at least 48 hours to process requests for prescription refills. This process takes more than just a few minutes. Remember that other patients have similar requests of our staff throughout the day. Please monitor your medications and contact us in advance.

Check with your pharmacy to determine turn around time. Some pharmacies allow you to refill your prescriptions via phone or fax. We recommend that you ALSO call our office if you or the pharmacy has not heard from us within 48 hours.

If you have not seen the doctor in the last 6 months, you may be required to schedule a follow-up appointment to discuss the medication.