FAQ & Forms
Deductibles & Copays
All insurance deductibles and copays are due at the time of service. We do not bill for copays. If you are a new patient, these amounts may be collected prior to your visit. If you are established with our practice, these copays may be collected as you depart after your visit. If your insurance eligibility cannot be confirmed prior to your visit, you will be responsible for the total visit amount on the date of service. Patients who have state funded insurance, i.e. Medicaid or Wellcare whose insurance cannot be confirmed will also be financially responsible for services rendered.
Unpaid accounts with no activity for ninety (90) days may be turned over to our collection agency which will result in a dismissal from our practice.
Prescriptions & Refills
No Show Appointments
Shot Records & Requests for Form Completions
Divorce, Separation & Custody Agreements
At Lifeguard Pediatrics we understand that issues related to divorce are very difficult for the entire family. However, we will not be party to custodial, separation or financial disputes relating to individuals with regard to minor children to whom services are provided. All copays, co-insurance and deductibles will be collected at the time of service from the individual accompanying the child at the visit. Both parents have access to the minor child’s medical records unless we are provided a copy of a court order that mandates otherwise.
“We maintain that divorce, separation and custody agreements should not take precedence over the provision of medical care for a child; such matters should remain between the parents.”
Forms
- Sports Physical form
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Sports Physical Form.
Athletes_with_Disabilities - Sports Physical form Spanish