Administrative Fees

No-Show

Appointments that are missed or not cancelled within four hours of the appointment time are subject to a $25.00 “no show” fee. You will be billed directly for this. Your insurance is not responsible for this fee.

Form Completion

All child/school physical forms are completed free of charge. Other simple one page forms(pre-employment, medication authorization for school, etc) are also completed free. For more extensive forms (SSI, FMLA, disability etc) the first completion per 12 months is free of charge. Each subsequent completion within the same 12 month will be $25.00.

Co-pay billing fee

If you are unable to pay your co-payment at the time of service, we will charge you a $5.00 service charge when we bill you.

Medical Records Copy

If you need urgent copies done by our office staff, there is a $25.00-$75.00 fee (depending on the size of the chart) for copies done in house. Otherwise, a copying service comes to our office every other week to copy records and they bill directly for their services.

Archived Charts

After three years of inactivity, charts are put in an offsite facility for storage. They are kept in storage for 7-10 years. If you need access to a chart in storage, a fee will be charged based on our cost to retrieve the chart.

Records Transfer

If you need to transfer your records to another physician, the records copying service will bill you directly.