following describes some of the financial policies at our office. Please read it carefully and please ask us any
questions you may have.
A. Patients, or their legal guardians, are
responsible for bills incurred for care or services provided by Dr. Ricca and his staff. This includes services that are not
covered by oneís insurance.
Payments of deductibles, copay's or co-insurance are required at time of service.
Patients who write checks that are returned for whatever reason will be charged a $30.00 returned check fee.
Patients with no or one insurance will need to make financial arrangements prior to any procedure.
If an account is sent to colletions for any reason, the patient or responsible party will be billed for the fee incurred by the collection agency.
patients need insurance, disability or other forms filled out. This is
a service separate from the medical care provided by Dr. Ricca. Completion of these forms is very time consuming and requires a
great deal of expense for Dr. Ricca and his staff. Because of this,
there is a fee of $35.00 for filling out simple forms. The fee for subsequent, similar forms for the same patient is $25.00. Complex forms are charged accordingly and you will be given a charge when we receive the form.
C. Fees will be
charged for patient chart reviews, preparing reports or letters for attorneys,
phone calls and appointments with attorneys or other professionals.
These charges are determined on a case-by-case basis.
D. Fees charged for patient medical record retrieval vary depending on size and method of delivery.
E. There may be a charge for mailing X-rays or other items on the patientís behalf.
710 Marion Street, Suite 303 Searcy, AR 72143 Ph: 501/278-8330 Fax: 501/278-8331