FINANCIAL POLICY STATEMENT

You can depend on receiving the highest quality medical care possible in a warm environment at Babies Etc. OB/Gyn P.C. Your comfort and well being are extremely important to us… and those concerns definitely extend into the payment options that are available to you. Our goal is to provide you with as many reasonable financial options possible for you to achieve your medical health desires.

YOU HAVE THE FOLLOWING PAYMENT OPTIONS:

Cash, check, Visa, Master Card, Discover on the day of service (additional fee when paying with debit/credit card or check).

Payment arrangements are generally made with established patients who have excellent payment history with this office.

As a courtesy to you, we will complete and file any applicable medical insurance forms for you and accept assignment of benefits as payment for up to 60 days. You will need to pay your estimated co-payment and deductible the day of your treatment. After 60 days, if your insurance has not paid, then you will be expected to pay your balance. We make every effort to get your insurance company(s) to pay the contracted rate. Any disputes with your insurance company or any delay in payment requires your attention.

During the course of your treatment you will receive monthly statements. Statements are rendered monthly with payment due by the end of the month. Any balance after the first statement will be subject to a finance charge of 1.5%

We hope this clarifies our office policy regarding your payment options. If you have any questions, please feel free to call our Billing Specialist at (256) 461-1766, Option 3

OTHER FEES

Patient request for copies of medical records: A flat fee of 5 dollars then a dollar per page up to 25 pages, after 25 pages its fifty cent per page.

FMLA Form Fee: $11.00 (allow at least 1 week for completion)