Fees and Charges
Billing and Collections
Returned Check Fee: $35
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Inability to pay insurance-mandated copay at time of service: $25 additional fee
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Collection Agency/Attorney Fees: We will make a reasonable effort to contact you regarding outstanding charges before turning over your account to a collections agency. Any outstanding balances past 90 days or more from the date of service are considered delinquent. Delinquent charges are subject to a $15 late monthly fee starting at 90 days from the date of service. In the event that your account is turned over to a collection agency or attorney after more than 90 days of delinquency on your account, you will be responsible for a collection fee equal to 33.3% of the outstanding balance due on the date the account is turned over for collection. Furthermore, you may be responsible for all legal fees which could include court costs for filing suit against you. Patients in delinquency may not be scheduled for future routine health appointments until attempts have been made to pay the balance due. Lastly, patients in delinquency status may be discharged permanently from the practice. If there are any billing questions, please contact our office staff and we will be happy to answer your questions.
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No Show and Late/Cancellation Fees
We will make every reasonable effort to remind you of upcoming appointments through various channels, however, it is your responsibility to cancel your appointment in a timely manner to avoid fees. If you are unsure of your appointment, please call us and inquire. Changes in time, date, or cancellation must occur at least 24 business hours prior to your appointment to avoid our inability to reschedule that time slot. If you arrive more than 15 minutes late to your appointment, you may be asked to reschedule your appointment.
We will assess the following fees for cancellation within 24 hours, no-shows, or late arrivals:
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Regular Appointments (15-20 min slot): $50
Physical Exam/Wellness Exam/Preoperative/Hospital Visit (30 min slot): $75
Copying, Printing or Transfer of Medical Records Fees
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Hard copies: $0.50 per page up to 50 pages $0.25 each additional page; Search/handling fee $20.00 plus all shipping costs; $150.00 Maximum Total
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Electronic copies: $0.37 per page up to 50 pages $0.18 each additional page; Search/handling fee $20.00 plus all shipping costs; $150.00 Maximum Total
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*Note charges are based on Virginia Law § 32.1-127.1:03 (J)), Code of VA § 8.01-413 (B) and are subject to change per Virginia code updates.
Telemedicine, Phone call, and After-Hours Fees
Telemedicine/Phone call visits in lieu of an in-person visit have variable insurance coverage. Whenever possible, we will notify you of the potential requirement of charges/fees payable outside of insurance for services rendered. For most insurances, telemedicine coverage only includes services with both video and audio communication (e.g. smartphone, tablet, computer). It may be possible to request a telephone-only visit with your doctor, however this is not covered by insurance in most cases. You will be responsible for the cost of the visit as a self-pay service should you opt for a telephone call and this service is not covered by your insurance plan.​
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Calls made after-hours (after business hours, weekends, holidays, etc) will be assessed a minimum self-pay fee of $75 if the doctor is required to provide services on your behalf. To avoid charges after-hours, any requests for refills, paperwork, cancellation of appointments, and general medical questions must addressed by calling during regular business hours (7:30 a.m. - 4:30 p.m., Monday-Friday).
Form Completion Fees:
We will assess a reasonable fee for paperwork (form) completion requiring a physician's signature, typically when completed outside of a doctor's appointment explicitly for the purpose of the form/paperwork. Please note: in many cases your doctor will request an office visit for completion of these forms at which time the forms will be completed included as part of the office visit. If you are unsure whether you will be required to pay for form completion, please inquire with our staff.
Range in fees is assessed based on complexity of paperwork and time required by physician/staff.
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Form completion: $50 and up, based on complexity
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CDL/DOT Examination and Paperwork completion: $150