Policies

Everyone's Time is Equally Valuable.

We ask that you arrive 5 minutes before your scheduled appointment time. We understand sometimes things happen beyond your control that may cause you to be late. However, we reserve the right to ask you to reschedule if you arrive late for your appointment.

Our practice makes every effort to run on time with appointments, as we believe everyone’s time is equally valuable.
Upcoming Appointments Via Phone/Text Message/Email

Missed Appointments: Broken appointments represent a cost to us, to you, and to other patients who could have been seen in the time set aside for you. We reserve the right to charge a fee for canceled or missed appointments. We request 24 hours notice for cancellation of appointments.

A fee may be charged for a second missed appointment. The third consecutive missed appointment will result in discharge from the practice.

For new patients, a fee may be charged if the FIRST appointment is missed.

Efficiency through the use of technology

You will be encouraged to consult our website, register for and use our patient portal, and effectively use automated reminders for appointments and for routine care/immunizations that are due.

The health and well-being of your children are our top priorities. We firmly support the expert guidance and recommendations provided by leading health authorities, including the American Academy of Pediatrics (AAP), the Centers for Disease Control and Prevention (CDC), and the Advisory Committee on Immunization Practices (ACIP). As such, our vaccine policy aligns with the evidence-based immunization schedule developed by these organizations.

We believe:

• Vaccines save lives. Immunizations have been proven to prevent serious illnesses, reduce the spread of contagious diseases, and protect vulnerable populations.
• Vaccines are safe. Extensive research and rigorous safety standards ensure that vaccines are both effective and secure for children and young adults.
• Vaccines protect communities. By vaccinating according to the recommended schedule, we help prevent outbreaks and protect individuals who cannot be immunized, such as infants too young for certain vaccines or those with certain medical conditions.

Our Policy Highlights:

• Recommended Schedule: We follow the immunization schedule endorsed by the AAP and ACIP because it has been carefully developed to provide the best protection at the most appropriate times.
• Evidence-Based Approach: Our recommendations are grounded in the latest medical research and data, reflecting a strong consensus among pediatric and public health experts.
• Transparent Communication: We are always available to discuss any questions or concerns about vaccines and are committed to providing clear, respectful information about the benefits and potential risks.

We understand that deciding how to protect your child’s health is one of the most important decisions you’ll make. By following this policy, we aim to ensure that every child in our care has the opportunity to grow up healthy, safe, and protected against preventable diseases.

Click here for our privacy policy.

Thank you for choosing Advocare Pennsylvania Union Medical Center (Advocare PUMC) as your health care provider. We are committed to building a successful physician-patient relationship, and the success of your medical treatment and care. Your understanding of our Practice Financial Policy and payment for services are important parts of this relationship. For your convenience, this document discusses a few commonly asked financial policy questions. If you need further information or assistance about any of these policies, please ask to speak with our Practice Manager.

When are payments due? All copayments, deductibles, patient responsibility amounts, and past-due balances are due at the time of check-in unless previous arrangements have been made with our billing coordinator.

How may I pay? We accept payment by cash, official check, VISA, MasterCard and American Express . We will only accept post-dated checks when they are provided within an approved payment plan.

Will you bill my insurance? Insurance is a contract between you and your insurance company. In most cases, we are not a party to this contract. We will bill your primary insurance company on your behalf as a courtesy to you. To properly bill your insurance company, we require that you disclose all insurance information, including primary and secondary insurance, as well as any change of insurance information. It is your responsibility to notify our office promptly of any patient information changes (ie, address, name, insurance information) to facilitate appropriate billing for the services rendered to you. Failure to provide complete and accurate insurance information may result in the entire bill being categorized as a patient’s responsibility. Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits. If your insurance company is not contracted with us, you agree to pay any portion of the charges not covered by insurance, including but not limited to those charges above the usual and customary allowance. If we are out of network for your insurance company and your insurance pays you directly, you are responsible for payment and agree to forward the payment to us immediately.

Which plans do you contract with? We accepts most major insurance plans. However, with the frequent changes that happen in the insurance marketplace, it is a good idea for you to contact your insurance company prior to your appointment and verify if we are a participating provider as per your plan.

What if my plan does not contract with you? If we are not a provider under your insurance plan, you will be responsible for payment in full at the time of service. As a courtesy, however, we will file your initial insurance claim, and if not paid within 45 days, you will be responsible for the total bill. After your insurance company has processed your claims, any amount remaining as a credit balance will be refunded to you.

What is my financial responsibility for services? It is your responsibility to verify that the physicians and the practice where you are seeking treatment are listed as authorized providers under your insurance plan. Your employer or insurance company should be able to provide a current provider listing. The patient or the patient’s legal representative is ultimately responsible for all charges for services rendered. “Non-covered” means that a service will not be paid for under your insurance plan. If non-covered services are provided, you will be expected to pay for these services at the time they are provided or when you receive a statement or explanation of benefits (EOB) from your insurance provider denying payment. Your insurance company offers appeal procedures. We will not under any circumstances falsify or change a diagnosis or symptom to convince an insurer to pay for care that is not covered, nor do we delete or change the content in the record that may prevent services from being considered covered. We cannot offer services without expectation of payment, and if you receive non-covered services, you must agree to pay for these services if your insurance company does not. If you are unsure whether a service is covered by your plan, ultimately, it is your responsibility to call your insurance company to determine what your schedule of benefits allows, if a deductible applies, and your potential financial responsibility.

What if I don’t have insurance? Self-pay accounts are used for patients without insurance coverage, patients covered by insurance plans which the office does not accept, or patients without an insurance card on file with us. Liability cases will also be considered self-pay accounts. We do not accept attorney letters or contingency payments. It is always the patient’s responsibility to know if our office is participating in their plan. If there is a discrepancy with our information, the patient will be considered self-pay unless otherwise proven. Self-pay patients will be required to pay in full for services rendered to them and will be asked to make payment arrangements prior to services being rendered. Emergency services provided to self-pay patients will be billed to the patient. At the sole discretion of the practice, extended payment arrangements may be made for patients. Please speak with our practice manager to discuss a mutually agreeable payment plan. It is never our intention to cause hardship to our patients, only to provide them with the best care possible and reasonable costs. I received a bill even though I have secondary insurance. Having secondary insurance does not necessarily mean that your services are 100% covered. Secondary insurance policies typically pay according to a coordination of benefits with the primary insurance.

What if I have billing or insurance questions?  Advocare PUMC is supported by a staff of dedicated professionals. Our office staff can assist with most financial questions and help relieve the patient/caregiver of burdensome paperwork. Please ask if you have any questions about our fees, our policies, or your responsibilities.

Do you bill other third parties? We do not bill third parties for services rendered to you. Our relationship is with you and not with the third-party liability insurer or policy carrier (eg, auto or homeowner). It is your responsibility to seek reimbursement from them. However, at your request, we will submit a claim to your primary health insurance carrier. You will be asked to pay in full for the services we provide you. All formalities required by your insurer and the third party should be promptly completed by you. If we receive a denial of your claim, you will be responsible for payment in full.

What if my insurance pays late? As a courtesy to you, we bill your insurance company for services on your behalf. If any insurance company fails to process payment for services within 45 days from the date of the claim submission, the total balance will be determined to be the patient’s responsibility.

Will I receive statements or bills? It is our office policy that all accounts with pending balances be sent two statements, each one month apart. If payment is not made on the account, a single phone call will be made to try and make payment arrangements. Accounts with unpaid balances for 90 calendar days or more will be sent to an external collection agency or attorney for collection. Unpaid bills can also lead to possible discharge from the practice. In the event an account is turned over for collections, the person financially responsible for the account will be responsible for the collections costs, including attorney fees and court costs. Regardless of any personal arrangements that a patient might have outside of our office if you are 18 years old or older and receiving treatment, you are ultimately responsible for payment of the service. Our office will not bill any other personal party.

Do you refer unpaid bills to collection agencies? If a patient cannot pay the balance on their account according to the financial policy will be referred to an outside collection agency or an attorney for further action.

What if my child needs to see a physician? A parent or legal guardian must accompany patients who are minors on the patient’s first visit. This accompanying adult is responsible for payment of the account, according to the policy outlined on the previous pages.

Do you charge a penalty for returned payments? Any charges incurred by the practice collecting balances owed to us during the collection process may be charged to the patient. Returned checks, credit card chargebacks, or returned payments will attract a minimum $35 penalty in addition to the balance owed. Accounts with returned payments will be expected to make payments via cash, money order, or cashier’s checks only.

Can you waive my copay? We cannot waive deductibles, coinsurances, or copays that are required by your insurance. This is a violation of insurance rules.

I have a hardship. How can you help me? Some patients may accrue large balances for services provided. At the sole discretion of the practice leadership, we will work with you to set up a mutually feasible payment plan. In some cases, if the minimum payment due cannot be paid, we will need proof of financial hardship. We may be forced to pursue collections of balances in the absence of tangible proof of hardship.

Do you charge for completing forms? Completing disability forms, FMLA forms, and other requested supplemental insurance forms requires time away from patient care and day-to-day business operations. A prepayment of $20.00 per form is required. Please understand that to complete forms, your medical record must be reviewed, forms completed and signed by the physician, and copied into your medical record. Some of these forms can be quite complicated and tedious to fill out. Please provide us with pertinent information, especially dates of disability and return to work. We request that you allow 5 business days for this process.

Do you charge for copies of medical records? Patients requesting copies of their medical records will not be charged a fee. Attorneys and Insurance companies requesting medical records will be charged a $15 fee plus postage and these fees:

· $0.25 per page – under 100 pages

· $0.10 per page – over 100 pages

· $15 for an itemized bill Expedited requests will be charged a special handling fee. Records requested via electronic media (flash drives, CDs, DVDs, etc.) will be charged an additional $10 device fee.

What if I missed my appointment to see the physician? We understand that on rare occasions, issues may arise, causing you to miss your appointment when you cannot notify our office before your appointment. Should you experience any unforeseen circumstance that causes you to miss your appointment, please call our office at least 24 hours prior to having it rescheduled. Our highly skilled physicians are committed to your well-being and have reserved time just for you. Patients who miss more than one appointment without notifying our office 24 hours before the appointment time are subject to a $20 missed appointment fee billed to the patient.



I have read, understand, and agree to the above Financial Policy. I understand my financial responsibility to make payments for services provided to me and the courtesy extended by Advocare PUMC Center to simplify insurance reimbursement for the services provided to me. I acknowledge that these policies do not obligate Advocare PUMC to extend credit to me for services provided.

Patient or authorized representative signature:                                                                                                                              Date:  __________________________________

___________________________________________________________________                                                                              
Patient or authorized representative name:

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We work hard to not overuse antibiotics.

We educate families on appropriate use of antibiotics, but follow evidence-based guidelines and don’t automatically treat ear pain or a green snotty nose with antibiotics.

We do not routinely prescribe antibiotics over the phone as we do not believe that is good medicine. We will prescribe an antibiotic when we believe it is an appropriate treatment.