Financial Policy

Please review the following information as it pertains to the financial policies of our practice:

Payment is due when services are rendered. We accept credit cards, personal checks, and cash. We also accept Care Credit. It is your responsibility to notify our office if there is a change in your insurance coverage.
We understand that circumstances arise when an appointment may need to be canceled or rescheduled. A 24-hour notice is required for an office visit cancellation or a cancellation fee may be charged to your account.
Returned checks will be charged a returned check fee of $25.00 plus any additional costs associated with them.
Your insurance company may request information or copies of records from you regarding other insurance coverage or have questions about pre-existing conditions. These answers are your responsibility and will require prompt response to prevent transfer of financial culpability to you.
We have agreements with most local insurance companies and other health plans to accept assignment of benefits. As a courtesy to you, we will file claims to them directly. You are required to pay all copayments, coinsurances, and/or deductibles at the time of your visit. Please be familiar with your insurance benefits in order to avoid confusion, delays, and unexpected financial responsibility.
If you are scheduled to have your annual/well-woman exam and present with additional problems, you may be responsible for a copay, coinsurance, and/or deductible for your visit.
Prior to most procedural and surgical services, we will contact your insurance company to verify benefits and advise you of your estimated financial responsibility. This portion of payment will be due prior to services. This process with your insurance company will be documented; however, this is not a guarantee of payment.
In the event that your insurance company determines a service “non-covered” you will be responsible for payment.
If you receive services by Dr. Yatawara at the hospital you may be billed separately for your stay, anesthesia, radiology, pathology, and laboratory services.
You will receive a statement of any remaining balances after your insurance company has paid its portion. If your balance is not paid, you will be sent to our collection agency, Statewide Collection Services. Our practice DOES NOT offer payment plans.
In the event that you have an overpayment on your account, we will apply this to future services unless you request a direct refund.

Financial Policy

Please review the following information as it pertains to the financial policies of our practice:

Payment is due when services are rendered. We accept credit cards, personal checks, and cash. We also accept Care Credit. It is your responsibility to notify our office if there is a change in your insurance coverage.

We understand that circumstances arise when an appointment may need to be canceled or rescheduled. A 24-hour notice is required for an office visit cancellation or a cancellation fee may be charged to your account.

Returned checks will be charged a returned check fee of $25.00 plus any additional costs associated with them.

Your insurance company may request information or copies of records from you regarding other insurance coverage or have questions about pre-existing conditions. These answers are your responsibility and will require prompt response to prevent transfer of financial culpability to you.

If you are scheduled to have your annual/well-woman exam and present with additional problems, you may be responsible for a copay, coinsurance, and/or deductible for your visit.

In the event that your insurance company determines a service “non-covered” you will be responsible for payment.

If you receive services by Dr. Yatawara at the hospital you may be billed separately for your stay, anesthesia, radiology, pathology, and laboratory services.

You will receive a statement of any remaining balances after your insurance company has paid its portion. If your balance is not paid, you will be sent to our collection agency, Statewide Collection Services. Our practice DOES NOT offer payment plans.

In the event that you have an overpayment on your account, we will apply this to future services unless you request a direct refund.

Reviewed and Updated January 22, 2017