N a n d r a
Family Practice
Our Family
Caring For Yours

Scheduling Appointments:
Please plan to arrive 15 minutes prior to your appointment to allow plenty of time to fill out the
mandatory paperwork.  

Please bring both your current insurance card and your driver's license or other photo ID to your
scheduled appointment.

If you prefer to fill out the registration form prior to your appointment, please click on the link below and
press print on your computers browser to obtain the form

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Missed Appointments:
Our policy is to charge for missed appointments not cancelled 24 hours before your scheduled time.  
These charges will be your responsibility and billed directly to you.  Please help us serve you better by keeping your
regularly scheduled appointment.

Insurance:
We participate in most insurance plans, including Medicare.  If you are not insured by a plan, payment in full is expected at
each visit.  If you are insured by a plan we do business with, but don't have an up-to-date insurance card, payment in full
for each visit is required until we can verify your coverage.  Knowing your insurance benefits is your responsibility.  Please
contact your insurance company with any questions you have regarding your coverage.

Co-payments and Deductibles:
All co-payments and deductibles must be paid at the time of service.  This arrangement is part of your contract with your
insurance company.  Failure on our part to collect co-payments and deductibles from patients can be considered fraud.  
Please help us in upholding the law by paying your co-payment at each visit.

Non-covered services:
Please be aware that some and perhaps all of the services you receive may be non-covered or not considered reasonable
or necessary by Medicare or other insurers.  You must pay for these services in full at the time of your visit.

Proof of Insurance:
All patients must complete a patient information form before seeing the doctor.  We must also obtain a copy of your driver's
license and current valid insurance card.  If you fail to provide us with the correct insurance information in a timely manner,
you may be responsible for the balance of the claim.

Claim Submission:
We will submit your claims and assist you in any way we reasonably can to help get your claims paid.  Your insurance
company may need you to supply certain information directly.  It is your responsibility to comply with their request.  Please
be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim.  
Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

Non-payment:
If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full.
Partial payments will not be accepted unless otherwise arranged.  

Coverage changes:
If your insurance changes, please notify us before your next visit so we can make the appropriate changes to help you
receive your maximum benefits.  If your insurance company does not pay your claim in 45 days, the balance will
automatically be billed to you.