5883 Glenridge Drive NE, Suite 100 | Atlanta, GA. 30328 | P: 404-303-1314 | F: 404-303-1399
COMPREHENSIVE PEDIATRIC CARE
All co-payments, deductibles, and balances owed are due at the time of service. These fees, by law, cannot be waived. For your convenience, we accept ATM cards, Visa, MasterCard, and American Express.
Payments for past due amounts can be arranged with our business office. Failure to pay or arrange payment of a past-due amount may result in a referral to a collection agency. If this occurs, you will be held responsible for all reasonable attorney fees, court costs, and collection fees related to the delinquent account. If your account is referred to a collection agency for payment, you may be dismissed from our practice.
*Please note: Patient Balances over 90 days old will require either payment to be made in full or payment arrangements to be made with our billing department prior to any well-child check or physical. Failure to comply will force us to reschedule the well-child check or physical until obligations are satisfied.
All medical records are the property of the Children’s Wellness Center and all requests for copies of medical records should be made in writing. We will happily provide copies of all required medical records to other primary care providers (should you move for example) or to specialists free of charge; however, any other copies will be charged per page to cover the costs of office staff and copying.
All requested copies of medical records will be provided to you within 30 days of receiving your written request.
Medical Transfer/Authorization to Disclose Health Information
If your insurance plan requires a referral prior to seeing a specialist or using a hospital service, we will need more than 24 hours notice.
We cannot issue a referral once services have been rendered. It is your responsibility to know the details of your policy and your insurance company’s requirements.
Missed appointments seriously disrupt our practice. Therefore, please give us at least 24 hours notice when cancelling an appointment. If you fail to show for a well-child appointment, you will be charged a $50.00 no show fee by our billing service. Cancellations with less than 24 hours notice and missed appointments will be charged. If you have three or more missed appointment, you may be discharged from the practice.