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Patient Care Policies

Insurance Card

  You will need to bring your most current insurance card to each visit for us to provide you with the most efficient billing service. Insurance companies and procedures change frequently, and our contracts with insurers require us to validate your insurance coverage each time we see you.

Co-Pay

  We are required to collect all co-pays at the time of service. For your convenience we accept Visa, Master Card, Discover, debit cards and personal checks.

Self-Pay

  For our self-paying patients we give a discount for payments made in full at time of services.

Returned Checks

  All checks returned to us will be charged a $25.00 returned check fee.

Delinquent Accounts

  Overdue accounts will be submitted to a collection agency, which will also be reported to the credit bureau.

Special Arrangements

  A payment arrangement can be made with our business office for past due amounts. All arrangements must be verified by the business office. Failure to pay or arrange payment of a past due amount within 120 days will result in a referral to a collection agency. If this occurs then you will be responsible for all reasonable attorney fees, court costs and collection fees related to the delinquent account.

Referrals

  If you're insurance plan requires a referral prior to seeing a specialist or using a hospital service then we will need greater than 24 hours notice. We cannot issue a referral once services have been rendered. It is your responsibility to know your insurance company requirements. We do not have access to that information.

Medical Records

  Medical records are the property of Salina Pediatric Care. You can request copies of medical records. Our charge for printing medical records is $18.18 + $0.60 per page for first 250 pages and $0.30 for additional pages. We will provide copies of required medical records to other health care providers free of charge.

Parental Guidance

  A parent or legal guardian must accompany all children/teens under the age of 18. The parent or guardian can designate another person to seek medical care for the minor by filling out a required form.

Missed Appointments/ Cancelled Appointments

  If you arrive 20 minutes after the scheduled appointment time will have to reschedule your appointment for a later date. If you fail to cancel with a 24 hour notice or do not show up for an appointment three times, you may be dismissed from the practice. We reserve the right to charge a $50 fee for appointments that are missed or cancelled with less than a 24 hour notice.