Financial Policy

Advanced Care Pediatric Center (ACPC)

ACPC FINANCIAL POLICY

PAYMENTS
  • Payment of all co-pays, co-insurance, or deductibles is due at the time of service.
  • Payment is the responsibility of the person bringing the patient in for care. This includes parents, guardians, or any adult with written permission to bring the patient to our office.
  • In cases of court-determined financial liability, third-party liability, accidents, or divorce, the person bringing the patient in is responsible for payment.
  • ACPC accepts cash, check, and major credit cards (Visa, MasterCard, American Express, and Discover).
PAPERWORK/ADMINISTRATION
  • ACPC will furnish a receipt for your records as proof of payment and any information required for you to file a claim with your insurance, if necessary.
  • Monthly statements will be sent for any unpaid balance. E-statements will be available as a service of the patient portal.
  • Your child’s health is my first priority and I will absolutely work with you in the event of unusual circumstances that may delay prompt payment.
  • There is a $30.00 charge for any check returned for non-sufficient funds.
INSURANCE
In order to bill insurance on your behalf, ACPC requires current insurance and patient information. Please provide a copy of your current insurance card at each visit and maintain the most updated information so that ACPC is able to file your claim correctly. If you do not provide ACPC with the correct information to file a claim, then you will be responsible for payment of the balance due.

Please review your insurance coverage carefully and be familiar with any limitations in coverage. For example, some insurance providers will cover check-ups, but may limit or exclude immunizations. ACPC will try to be aware of general policy with our more common insurance carriers but cannot be responsible for details of your specific coverage.
MISSED APPOINTMENTS
I do not double-book (or triple-book) my appointments. Your appointment is your time. If, for some reason, you are unable to make your appointment, there will be no other patient to take your allotted time.

To retain this level of service to you and your child, I will charge for missed appointments. Please make every effort to keep your appointments.