Failure to cancel a visit or notice of less than 24 hours of being unable to attend an appointment may result in a charge to you. This charge can be as much as the equivalent of the total charge, which would have been applied. Insurance often will not cover this charge.

We are committed to providing you with the best possible care, and we are happy to discuss our professional fees with you at any time. Your clear understanding of our financial policy is important.

Full payment for services is due at the time the service is rendered unless other arrangements have been made with our office. We accept cash, personal checks, VISA and Mastercard.

You will receive a separate billing statement for each doctor that your child sees and separate payment is required for each. After 60 days any account with an outstanding balance will accrue a $3.00 rebilling charge each month until the account is paid in full. Delinquent accounts may be referred to a collection agency. If your account is sent to collections your child will no longer be seen by any doctor in this office. There will be a $5.00 billing fee for all co-payments not paid in full at the time of service.

You are responsible for understanding the insurance policy you have chosen, and for providing our office with all necessary billing information. Please read the benefits of your individual policy. There are some services that may not be covered by your insurance. Payment is expected at the time of service for non-covered charges. Co-Payments are required at the time of service.

We participate with many insurance carriers and will gladly submit claims directly to them. We are unable to submit claims to those carriers with which we do not participate. In this situation, payment is due in full at the time of service and we will provide you with all the necessary forms so that you are able to request reimbursement from your insurance carrier directly. The following is a list of some of the carriers with which we do not participate:

All Discount Cards
CCN
Colorado Access
Community Health Plan of the Rockies
First Health
Fortis (unless through Sloans Lake or PHCS)
Golden Rule (unless through Sloans Lake or PHCS)
Kaiser
Mailhandlers
Pacificare for CU employees as of 7/1/07
USA Life Network

The previous list is not all inclusive, but is instead a partial list of the most common carriers with which we do not participate.

If you have any questions about or are unable to meet the terms of our financial policy, please feel free to contact our Business Office at (303) 545-5679.

When you move or leave our practice, one summary copy of your child's records will be sent without charge to whomever you designate. A written release of records is required. Please allow two weeks for delivery of record.