Financial Policy
All co-payments will be collected at the time of service before your visit with the provider. Deductibles,
co-insurance and any unpaid balance will also be collected at the time of service. As a courtesy to you, we will
file your claim for you. If we do not participate with your plan, payment is expected at the time of service.
As always, for your convienience we accept cash, checks, VISA and MasterCard.
If your insurance has not paid after sixty (60) days, it becomes the patient’s responsibility. We ask that you
please follow-up with your insurance company and keep us informed as to the status of your claim. If we may
assist with timely payment of your insurance claim, please contact our Practice Manager.
There is a fee of $35.00 for any returned checks. Varying fees are charged for forms or letters that may be requested.
Charges for copying medical records are based on the charges set forth by the Georgia Office of Planning and Budget
pursuant to O.C.G.A. 31-33-3. In order to comply with HIPPA regulations, a signed, written request for medical
records must be received along with payment before records can be released.
There is a fee of $25.00 for completion of forms and letters by our providers, which will be collected when the paperwork is released.
Patients who “no show” for an appointment will be charge a fee of $25.00. Our office requires a 24 hour notification to cancel a scheduled appointment.
If you need to cancel an appointment outside our regular office hours, you may send a message via our patient portal or call 770-886-3842 and leave a message for the appointment desk.
It is the patient;s responsibility to keep up with their scheduled appointments, but as a courtesy we do our best to provide reminder calls to our patients the day before the scheduled appointment.
If you are a Private Pay patient, payment will be expected at the time of service unless other arrangements have been made with our Practice Manager.
Statements will be mailed to you every thirty (30) days for up to 90 days. One collection letter will be
mailed to you after the last statement. Unpaid accounts may be referred to an outside collection agency if not paid
within 120 days from the date of service.
Please feel free to contact our office with any questions or concerns. We will be happy to talk with you about your insurance coverage or any other financial matters related to your care.
