Financial and Office Policies

•  Patient Responsibility: We participate in many insurance plans. We recommend that you familiarize yourself with your insurance benefits and confirm our participation in your plan. Most misunderstandings about insurance can be avoided if you understand what your policy covers. Please contact your insurance company with any questions regarding your coverage.
•  Insurance Carriers Requiring Referral: If you are referred to a specialist and your insurance carrier requires a referral number, our office must receive at least 7 days' notice to complete that referral.
•  Proof of Insurance: All patients must complete their patient information form before seeing the doctor. We must obtain a copy of your valid government-issued identification and a current, valid insurance card. Please bring these items on each visit. Payment in full is required if we are unable to verify your current insurance information.
•  Payments Due at the Time of Service: Co-pays, deductibles, cash-pay fees, or fees not covered by insurance are due at the time of service.
•  Nonpayment & Returned Checks: Unpaid accounts will be referred to an outside collection agency and may result in dismissal from the practice. A $30 fee will be charged for all returned checks.
•  Late Arrivals: Please arrive 15 minutes before your appointment. If you arrive late, our office may need to reschedule your appointment to a new time or date. Patients who are on time will not be delayed accommodating late arrivals.
•  No-Shows: Please notify us 24 hours in advance if you must cancel or change your appointment. Failure to do so will result in a $35 no-show fee that is not covered by your insurance. A third no-show may result in dismissal from the practice.
•  Cancellations: If you cancel within 24 hours of your scheduled visit, you will be subject to a $35 cancellation fee applied to your account.
•  Referrals: The providers at Primecare360 may refer you to providers outside the practice. It is the patient's choice to receive ancillary healthcare services from any ancillary healthcare provider or facility of their choice.
•  Form Completion: All forms requiring medical review and physician signature—including school, daycare, and camp physicals, prior authorizations, FMLA, disability, or other paperwork—may incur an administrative fee of $30. Administrative fees may be waived if the patient has a scheduled appointment in conjunction with form completion.
•  Lab Draws: Labs will not be completed prior to the office visit but will be performed during that visit or on a subsequent day as necessary. Blood Draw / Lab Services on site is provided as a convenience by the third party to the patient. Any bills from the lab are your responsibility and it is not associated with the services provided by the Primecare360.
•  Refills: If you miss or cancel your appointment, refills will not be provided. Refill requests are processed Monday through Friday. If you need a refill, please contact your pharmacy so they may send a digital request. Refills will not be called in or sent after business hours or at weekends.
•  Policy Acknowledgment: I have read and understand the Financial and Office Policies of Primecare360 and agree to abide by its guidelines

Your insurance policy is a contract between YOU and YOUR insurance company. It is your responsibility to understand your benefits and obtain any necessary referrals. We file claims on your behalf. Any non-payment of claims from your insurance company will be billed to you directly.