FINANCIAL POLICY

Thank you for choosing Women’s Health Group as your women’s health care provider. We are dedicated
to delivering high-quality and accessible healthcare services. Below, you will find our updated payment
policy guidelines.

Insurance Coverage:
We accept most insurance plans. If you are uninsured by a plan we do business with, full payment is
expected at the time of your visit. For patients with insurance coverage but without an insurance card,
please provide an updated copy at check-in to facilitate successful billing of your claims. Failure to furnish
proof of coverage may result in responsibility for the outstanding balance.

Copayments and Deductibles:
All copayments and deductibles must be settled at the time of service, as outlined in your contract with
your insurance provider. Collecting these payments promptly is crucial to compliance with legal
requirements and helps us maintain integrity in billing practices.

Credit Card on File:
We require all patients to keep a credit card on file, without exceptions. These card details will only be
charged for services not covered by your insurance.

Claims Submission:
We will handle the submission of your claims to your insurance provider, but you may be required to
supply additional information directly to them. Fulfilling their requests promptly is your responsibility, as
your insurance benefit represents a contractual agreement between you and your insurer. Failure to
complete the requirements will result a full payment due.

Pre-procedural Estimates:
Efforts are made to verify coverage and obtain estimates for services beforehand. Please note that these
estimates are approximate, and final payments may differ. Payment for estimated amounts is due before
procedures commence. Refunds, if applicable, will be issued within 30 days of receipt of insurance
payments. Please refer to a separate agreement for obstetrical patients.

Coverage Changes:
Should there be changes to your insurance coverage, kindly inform us before your next appointment so
we can update our records accordingly to ensure you receive maximum benefits.

Nonpayment:
Accounts overdue by more than 60 days will receive a notification letter, with a 15-day grace period to
settle the outstanding balance. Failure to do so will result in the inability to schedule future appointments
until the account is resolved.

Acknowledgment:
By agreeing to this policy, you understand that failure to make satisfactory payment arrangements may
result in your account being transferred to an external collections agency. You authorize Women’s Health
Group and the designated external collection agency to contact you via phone, text, and/or email using
the provided contact information.

We are committed to providing exceptional care to our patients. By reading and agreeing to these
payment guidelines, you acknowledge your commitment to adhering to our policies.