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Pediatrics Policies

Discounts and Payment Responsibilities

We offer a 10% discounted rate for patients that do not have insurance and pay for their visit, IN FULL, at the time services are rendered. We take an estimated amount in the form of a deposit before the time of the examination and any additional services that are provided must be paid IN FULL at the end of the visit.

Late/No Show Policy

Please be advised that you are expected to arrive 15 minutes prior to your appointment time in order to allow for check-in and registration.

If you arrive later than 20 minutes after your scheduled appointment time, you may be asked to re-schedule or be seen as a walk-in if there is a provider available.

If you are unable to make your appointment, please call and re-schedule so that other patients can be accommodated. If you do not show up for your appointment and do not call to cancel at least 24 business hours prior to your appointment, you will be considered a no show, and you will be charged a $50.00 no show fee for regular office visits and $75.00 for missed physicals. Once you have acquired three no shows or late appointments, you may be asked to find a new primary care provider.

Co-payments and Deductibles

Your co-payment is a contractual agreement between you and your insurance company that you are expected to make payment at the time of your visit. If you are unable to pay your co-payment at the time of service, you will be charged a $25.00 missed co-pay fee.

If you have an un-met deductible, we will collect the amount of the visit up to the un-met deductible amount. Any overages paid will be refunded to you.

Laboratory testing

A provider may need to rely on results of laboratory testing along with a physical exam to determine a diagnosis and course of treatment. We perform a few simple laboratory tests (urinalysis, strep, urine pregnancy, and mono) here at our clinic.

Some tests may need to be sent to an outside lab for further examination. You will receive a separate bill from the laboratory for which you will be responsible. Your medical insurance frequently pays for all or a portion of these charges. If you do not have insurance there are discounts for some tests, so please discuss these with the nurse.

Prescription Refill Requests

It is our policy that all prescription refill requests are processed within 24-48 hours from the time of the request. Please understand that prescription refills may not be authorized by the provider.

After Hours Physician Line

We have a provider “on call” after our office is closed to take care of your after-hours urgent medical needs. No refills on medications will be done after hours.


We charge a fee to complete forms, letters, or additional paperwork that you request from the provider. The charge for the first 5 pages is a flat rate of $29.00. After the first 5 pages, the flat-rate charge is $58.00. Alternatively, you may schedule an appointment with the provider to have the forms completed at an office visit. For completion of forms outside an office visit, payment will be collected at the time the forms are picked up. Forms require 3-5 business days to be completed.