Policies

Cancellations & No Shows

Our office requires a 24 hour notice for all cancellations. The fee also applies to same day notice. There is a $40.00 fee for missed appointments. This courtesy allows us to be of service to other patients who are in need of our care.

Appointment reminder calls are provided as a courtesy and are not required. It is your responsibility to be here on time for your appointments.

Return Checks

There is a $35.00 service charge for all returned checks. Guarantor accounts/patients accounts with returned checks will be on a cash or credit card basis for ALL future visits.

Miscellaneous Fees

We charge a $25.00 fee to copy medical records. We also charge $25.00 to write letters on behalf of the patient and to fill out disability/ work related forms.

A $35.00 fee will apply when an acute medical problem is treated over the phone and a medication is called into your local pharmacy.

Contacting your Former Doctor

Our Medical Assistants are available to assist you in communicating medical issues with your physician. They are pleased to relate questions regarding medications, symptoms and treatments. They will make every effort to return your call the same day.

This is the best way to take care of a problem quickly, though it may ultimately require an office visit. Dr. Levine will not take calls from patients while in consultation.

Diagnostic Procedures

Our medical assistant will assist in pre-authorizing all diagnostic procedures requested by our doctors. Scheduling the procedure(s) is the responsibility of the patient.

Our office will provide you with contact information if requested.

Emergencies

Our office provides coverage 24 hours-a-day, seven days a week. If you have an urgent problem, please call the office for instructions. If you call after normal working hours, our answering service will take a message and contact Dr. Levine. Please try to keep your telephone line free when waiting for an emergency call back so that Dr. Levine can reach you.

Insurance & Patient Payments

Our Billing Department assists patients in getting their claims paid at the highest benefits provided by their insurance carrier(s). You can contact our Business Department regarding insurance questions.

Our contracts with the insurance companies require us to collect your co-payment, patient percentage and/or deductible or your portion of the cost at the time of your visit. Please be prepared to pay this when you arrive for your appointment. For your convenience, we accept payments by cash, credit card or check.

Any outstanding balance will be collected in full upon check-in, prior to your visit with Dr. Levine. This will help facilitate your discharge from the office.

Self-pay patients (no insurance coverage), will be expected to pay for the office visit in full at the time of service, unless previous arrangements have been made with our Billing Department.

You must be prepared to provide your insurance card at every visit.

We will not become involved in disputes between you and your carrier.

In the event your insurance plan determines any service to be “not covered,” you will be responsible for the complete charge.

To make a payment by phone call our office at (409) 347-3621.

Lab & Test Results

If any lab or test shows abnormal results that require immediate follow-up, your physician will contact you directly.

Past Due Accounts

Our credit and collection policies are a necessary part of assuring the financial resources needed to sustain our practice.

Past due accounts (after 90 days) are referred to a collection agency.

For inquiries regarding payment arrangements call (409) 347-3621.

Failure to keep an account current through regular monthly payments may result in an additional charge to service the account and the denial of future credit.

Statements

Statements are mailed monthly to patients with remaining balances on their account.

Full payment is due upon receipt of a statement.

All outstanding balances must be paid prior to your next office visit, unless arrangements have been made with our Office Manager.

Balances are considered Past Due after 30 days.

We do accept payment by phone.