For a copy of our financial policy, please visit the "Forms" page.
Appointment Change/Cancellation Policy
If you are unable to keep your appointment as scheduled:
Please understand that we reserve each appointment slot specifically for that patient without double-booking. When a no-show or late change occurs, patients who need to be seen may be unable to rearrange their personal schedules to take advantage of the new opening. Therefore, we have implemented an appointment cancellation policy which enables us to better utilize available appointments for patients in need of care. Failure to cancel your appointment without a full 24-hours’ notice is considered a “No show.” No shows will be billed $150 for established patients per occurrence and $200 for a new patient visit. Due to our clinic being a primary care provider, exceptions are not made in cases of acute illness. Keeping the appointment is especially encouraged so we can help support your child’s natural defense in the face of illness. If acute illness occurs, please call our front desk to update us on symptoms, and we may encourage patients to add a COVID test prior to the appointment. No shows are not billable to insurance and are patient responsibility. We reserve the right to dismiss patients from our practice after 3 no-show appointments.
If you are unable to keep your appointment as scheduled:
- We request at least 48 hours’ notice to allow for patients on the waitlist to be able to squeeze in.
- However, we require at least a full 24 hours’ notice to make appointment changes.
- We encourage patients to keep their appointments as scheduled in order to stay current on wellness plans. Even when patients are feeling better and think they no longer need the appointment, it is helpful to meet with the provider to keep the provider updated on the patient's health and to make sure the provider did not have other plans for next steps.
- Please call 503-643-2100 as soon as possible to make any necessary changes.
Please understand that we reserve each appointment slot specifically for that patient without double-booking. When a no-show or late change occurs, patients who need to be seen may be unable to rearrange their personal schedules to take advantage of the new opening. Therefore, we have implemented an appointment cancellation policy which enables us to better utilize available appointments for patients in need of care. Failure to cancel your appointment without a full 24-hours’ notice is considered a “No show.” No shows will be billed $150 for established patients per occurrence and $200 for a new patient visit. Due to our clinic being a primary care provider, exceptions are not made in cases of acute illness. Keeping the appointment is especially encouraged so we can help support your child’s natural defense in the face of illness. If acute illness occurs, please call our front desk to update us on symptoms, and we may encourage patients to add a COVID test prior to the appointment. No shows are not billable to insurance and are patient responsibility. We reserve the right to dismiss patients from our practice after 3 no-show appointments.
Requirements for Each Visit
- Current insurance card is presented to front desk
- Contact information verified
- Any changes in insurance coverage are reported to front desk when scheduling your appointment
- Patients are requested to verify their insurance coverage and our network participation with their insurance plan before each visit by contacting their insurance company directly
- Completed Good Faith Estimate (if applicable) submitted at every appointment.
Membership (formerly "Admin") Fee
Due annually whether paid-in-full or with payment plan.
Due annually whether paid-in-full or with payment plan.
Co-Payments, Coinsurance, Deductibles, etc.
Co-payments, coinsurance, and deductible payments are due at the time of service.
Co-payments, coinsurance, and deductible payments are due at the time of service.
Insurance
Integrative Pediatrics will gladly submit claims to most insurance carriers. We also offer Secondary and Tertiary billing. In the event of a Motor Vehicle Accident, we will submit your claim(s) to the motor vehicle carrier. All insurance and contact information must be reported to us at the time of scheduling and all insurance cards must be provided annually. Please note:
Integrative Pediatrics will gladly submit claims to most insurance carriers. We also offer Secondary and Tertiary billing. In the event of a Motor Vehicle Accident, we will submit your claim(s) to the motor vehicle carrier. All insurance and contact information must be reported to us at the time of scheduling and all insurance cards must be provided annually. Please note:
- Financial Policy document must be submitted annually.
- Patients are requested to verify their insurance coverage and our network participation with their insurance plan before each visit by contacting their insurance company directly
- A Good Faith Estimate must be completed in order to receive services if we are out-of-network with your plan, or if you are uninsured.
If You Are Uninsured
If you are uninsured, or if we are unable to verify coverage, we require a $100.00 deposit at your first visit, which will be applied to your charges. If charges exceed the $100.00 we will send you a statement.
No Surprises Act—Balance Billing Protection
Good Faith Estimates (GFE) are both available and required for uninsured or self-pay patients, or for patients with out-of-network insurance. Please let us know if you are uninsured, or if we are out-of-network with your insurance plan. To read our general notice, please visit this page. Thorough notices are given with the Good Faith Estimate. To learn more about Good Faith Estimates, balance billing protection, and the No Surprises Act, please visit this page.
If you are uninsured, or if we are unable to verify coverage, we require a $100.00 deposit at your first visit, which will be applied to your charges. If charges exceed the $100.00 we will send you a statement.
No Surprises Act—Balance Billing Protection
Good Faith Estimates (GFE) are both available and required for uninsured or self-pay patients, or for patients with out-of-network insurance. Please let us know if you are uninsured, or if we are out-of-network with your insurance plan. To read our general notice, please visit this page. Thorough notices are given with the Good Faith Estimate. To learn more about Good Faith Estimates, balance billing protection, and the No Surprises Act, please visit this page.
Medical Records Fees
We are a medical home; our philosophy of primary care is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. When you transfer care you are no longer our patient. Transfer of records to a new physician will be sent complementary. Subsequent new provider transfers will be charged $75.00; payment is required prior to release of records. If balance is not paid in 30 days, your account will be billed.
For personal copies of medical records: $25.00-$300.00 fee per medical record (depending on size). We will call you upon readiness of records and payment is due at that time. We can mail your records if requested, for an additional charge. If you request to pick them up and have not done so by 30 days, your records will be mailed to the address you provided and shipping and handling will be added to your account balance.
We are a medical home; our philosophy of primary care is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. When you transfer care you are no longer our patient. Transfer of records to a new physician will be sent complementary. Subsequent new provider transfers will be charged $75.00; payment is required prior to release of records. If balance is not paid in 30 days, your account will be billed.
For personal copies of medical records: $25.00-$300.00 fee per medical record (depending on size). We will call you upon readiness of records and payment is due at that time. We can mail your records if requested, for an additional charge. If you request to pick them up and have not done so by 30 days, your records will be mailed to the address you provided and shipping and handling will be added to your account balance.
Unpaid Accounts
We take many steps to avoid collections, however if your account is placed with a collections agency you will be assessed a $100 collection fee. This will be added to your final balance placed with the collection agency and you will also be responsible for all legal fees, interest, and court costs involved.
We take many steps to avoid collections, however if your account is placed with a collections agency you will be assessed a $100 collection fee. This will be added to your final balance placed with the collection agency and you will also be responsible for all legal fees, interest, and court costs involved.
We are contracted with many insurance companies, however it is important for you to verify directly with your insurance company if our providers are participating with your medical plan prior to receiving services. Please inform us if you are using an insurance plan with which we are out-of-network, or if you are uninsured, so that we can provide you with a Good Faith Estimate for your upcoming visit.