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Dear Patient,
Thank you for the opportunity to serve you. Customers like you are responsible for our
growth and we never forget that fact. If you ever have a question regarding your account
or if, for some reason, you are not satisfied, do not hesitate to let us know.
Patient Confidentiality:
Please be assured that only our billing/credit department uses your personal information
and will be held in strict confidence.
Our Company Policy States:
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With proof of insurance: Primary or secondary, we will bill for you free of
charge. Insurance is filed after services are rendered. After we received reimbursement
from your insurance, you will be billed the remainder. This amount is due 30 days post
our statement date.
We will file your insurance as a courtesy. In the event your insurance may need additional
information, it is your responsibility to respond since any delay will result in delay of
payment.
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Without insurance: Payment is expected at time services are rendered,
unless previous arrangements have been made.
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In the event an account defaults, all legal and/or processing fees will be added to the
unpaid balance and be the responsibility of the account holder.
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We accept cash, debit/credit, Mastercard, Visa, Discover and also American Express. There
will be a $25.00 fee for all returned checks.
If you have any questions, please contact our office prior to making your appointment.
Otherwise, please download our financial form, complete it, and bring it
along to your appointment.
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