Financial Policy
This notice describes requirements for insurance and payments for your medical care. Please review it carefully.
For Patients With Insurance
We will accept assignment of benefits from your primary insurance and one other insurance. A copy of your insurance card(s) is required by our office, and any changes must be brought to the office’s attention. Failure to provide our office with current insurance information that leads to non-payment from the insurance company will result in the balance being transferred to the patient responsibility.
Co-pay/Deductibles
Co-pay or deductible payments are due at the time of service unless prior arrangements have been made. Payment may be made by cash, check, credit card, debit card, or money order.
Claims Submission
We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. If you do not supply this information within a timely manner, you may be responsible for the balance of a claim. If your insurance changes, please notify us before your next appointment so we can make the necessary changes to help you receive your maximum benefits.
Non-Covered Services
Please be aware that Medicaid and some insurance companies consider certain services as non-covered services. Therefore, you will be expected to pay for these services. We are not responsible for knowing your insurance policy coverage. You must contact your insurance company to determine what your policy will cover.
Newborns
Newborns must be added to your insurance plan within the first 30 days after birth for charges to be paid by your insurance.
Co-pay/Deductibles
Co-pay or deductible payments are due at the time of service unless prior arrangements have been made. Payment may be made by cash, check, credit card, debit card, or money order.
Claims Submission
We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. If you do not supply this information within a timely manner, you may be responsible for the balance of a claim. If your insurance changes, please notify us before your next appointment so we can make the necessary changes to help you receive your maximum benefits.
Non-Covered Services
Please be aware that Medicaid and some insurance companies consider certain services as non-covered services. Therefore, you will be expected to pay for these services. We are not responsible for knowing your insurance policy coverage. You must contact your insurance company to determine what your policy will cover.
Newborns
Newborns must be added to your insurance plan within the first 30 days after birth for charges to be paid by your insurance.
For Patients Without Insurance
We require payment in full for services provided to patients with no insurance. Payment may be made by cash, check, credit card, debit card, or money order.
Other Financial Policies
We understand that medical costs can be high, and therefore funds are not readily available, and payment arrangements may be necessary. It is our policy that these arrangements be made prior to services being performed. We will have you sign an agreement with specific arrangements for payment
Usual and Customary Rates
Our practice is committed to providing the best treatment to all our patients, and we charge what is usual and customary for our area.
Divorced Parents
The parent who accompanies the child to the appointment is responsible for the payment of services unless prior arrangements have been made with our office.
Missed Appointments
If an appointment is not cancelled at least 24 hours before the appointment (or at the time of appointment confirmation), you may be required to pay a no-show fee of $25. For more information, see our No-Show/Late Cancellation Policy.
Non-Routine Care During Check-Ups
Discussion of any new, ongoing, or worsening symptoms that Dr. Kim needs to diagnose and/or treat during well-child care visits will be billed separately as a sick visit. You may be required to pay a copay, deductible, or co-insurance.
What is Not Covered During Preventative Care:
Usual and Customary Rates
Our practice is committed to providing the best treatment to all our patients, and we charge what is usual and customary for our area.
Divorced Parents
The parent who accompanies the child to the appointment is responsible for the payment of services unless prior arrangements have been made with our office.
Missed Appointments
If an appointment is not cancelled at least 24 hours before the appointment (or at the time of appointment confirmation), you may be required to pay a no-show fee of $25. For more information, see our No-Show/Late Cancellation Policy.
Non-Routine Care During Check-Ups
Discussion of any new, ongoing, or worsening symptoms that Dr. Kim needs to diagnose and/or treat during well-child care visits will be billed separately as a sick visit. You may be required to pay a copay, deductible, or co-insurance.
What is Not Covered During Preventative Care:
- New or updated medications for acute or chronic conditions
- Extended discussion and/or treatment of mental health or behavioral concerns beyond the scope of a well-child exam
- Extended discussion and/or treatment of physical symptoms beyond the scope of a well-child exam (headaches, stomach aches, earaches, rashes, etc.)
- Treatment of injuries
Last Updated January 2025
Reason for Update: Clarification of no-show policy.
Reason for Update: Clarification of no-show policy.
