5363 Balboa Boulevard, Suite 540 · Encino, CA 91316
EMAIL firstname.lastname@example.org · PHONE 818.905.6600 · FAX 818.905.6610
The following is a list of the insurances accepted and applicable office policies:
|PPOs||We are in-network with most major PPOs, including Anthem Blue Cross, Blue Shield, Aetna, Cigna, United,Tricare and Motion Picture/Industry Health Network.||We ask that all co payments be paid at the time of the visit. After the insurance company has processed the claim, we will send a bill for the outstanding balance. This can include unmet deductibles, co-insurance, or non-covered services. Payment is due upon receipt.|
|HMOs||We are contracted with the following medical groups: Healthcare Partners, Regal Medical Group, Lakeside Medical Group, Premier Physicians Network, High Dessert Medical Group, Preferred IPA, Serendib and Facey Medical Group.||These medical plans require a referral from your primary pediatrician or from a specialist in the same medical group.|
|We do accept patients who have no medical insurance.||For patients with no insurance coverage or with insurance where we are not a contracted provider, payment is due at time of service. We accept cash, checks, Visa and MasterCard. Out of courtesy, we submit all claims to your insurance, and you get reimbursed directly from your insurance at your out-of-network rates.|
IT IS THE RESPONSIBILITY OF THE PATIENT TO NOTIFY OUR OFFICE OF ANY CHANGE IN INSURANCE, MAILING ADDRESS, OR CONTACT INFORMATION.