It is the policy of Laser Derma Care Center that payment is due at the time services are rendered including HMOs, PPOs, Medicare and Medicaid co-payments and/or deductibles. Other exceptions to this policy must be arranged in advance with the Patient Accounts Coordinator. Account balances over ninety (90) days on which no payment has been made, may be subject to collection activity.
I understand that health insurance is an agreement between me and my insurance company to pay a specified amount for medical care. My doctor's fees are not based on the amount insurance will pay. The amount approved by my company for payment on a particular procedure may more or less than the fee charged. I understand that full payment for my treatment remains my exclusive responsibility including HMOs, PPOs, Medicare and Medicaid co-payments and/or deductibles, even for charges not paid by my insurance carrier. I understand further that payment in full or installment payments are due no later than forty-five (45) days after any and each treatment, regardless of the status of any insurance claim at that time.