Financial Policy


You chose us to provide medical care for your child(ren) and we are committed to providing the best care available. As with any other business relationship, we each have expectations and we would like to make these clear so there are no misunderstandings.

Most importantly, you are financially responsible for the care we provide.

What you can expect from us:

  • We will maintain agreements with managed care plans where appropriate to our business
  • We will file your insurance claims for plans with which we participate for you after each visit
  • We will provide you with the fees associated with your care whenever you request them
  • We will work with you in the event of a special financial need

What we expect from you:

  • You will know and understand your own benefits
  • You will bring your insurance card to each visit
  • You will pay your copay, co-insurance, deductible, or any outstanding balance at the time of service (we accept Visa, Mastercard, checks, and cash)
  • You will pay in full at the time of service if you are not covered by a plan with which we maintain an agreement, if the services provided are not a covered benefit, or if we are not able to verify your coverage at the time of service
  • You will be charged a $25 fee for missed appointments (“now show,” or if appointment is cancelled within 24 hours from appointment time)
  • We do Not file secondary insurance claims, but will provide you with a copy of the charges for you to file with your secondary insurance carrier
  • This policy constitutes our agreement with each other on the financial aspects of the medical care we provide
Office Documents

These links will allow you access to printable office forms. Note these forms should not be emailed back to the office. If you prefer, you can fax these to us at 770-772-6099, or bring them with you on your next visit."