Because of the burden that certain actions have on the practice, patients will be assessed fees in special circumstances, noted below.
Missed Appointment No Call: Patients who fail to inform the office that they will miss an appointment shall be assessed a fee of $25.00
Form Completion Fee No Visit: Patients presenting a form for completion by the doctor outside of a visit will be assessed a fee of $5.00 per page
Medical Records Copy Fee: Patients are allowed up to 10 pages of their medical record at no cost. Subsequent or additional record copies shall be assessed the Commonwealth of Pennsylvania allowed record copy rates, payable in advance.
No Co-payment Paid on Date of Service: Patients failing to pay on the date of service the co-payment specified by their insurance plan shall be assessed a fee of $10.00
Returned Check Fee: Patients presenting a bad check will be assessed a fee of $20.00 in addition to any other actions that might be taken.
Bad Debt Fees: Accounts sent to a collection agency or attorney for collection shall be assessed the costs of doing so within the fee limits set by the laws of the Commonwealth of Pennsylvania.
Please note that these fees will be treated as a lawful charge, just as those related to any other service provided. Failure to pay these fees will be handled as any other lawful assessment.
The fees shown above are subject to change without notice except as may be required by law.
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