New Patient Forms:
Patient Registration Form
New Patient Registration Form
HIPAA Restrict Form
Late, Cancellation, and Missed Appointment
Rapid Health Assessment
No Shows and Late Cancellations
Co-Payments and Insurance Deductibles
Co-payments and insurance deductibles represent the portion of our services that patients must pay out of pocket. Such payments are required by the patient’s agreement with the insurance payer, and our contracts with the insurance payers require us the collect them. No waivers can be allowed. For Medicare, law requires collection of deductibles and co-payments, and waiver of such payments constitutes fraud. To comply with our contracts, ARAC requires payment in full at the time of services including any co-payments and deductibles. Any payment past due must be made before the next scheduled visit can proceed.
In an effort to serve our patients and the community well, we must utilize our time efficiently. When a patient makes an appointment, time is set aside for their needs, and work is performed to prepare their record for the visit. When a scheduled visit is not completed, there is a loss for another patient who needed treatment. For late cancellations or not showing for a scheduled appointment, a $25 fee will be charged.
The employees of ARAC strive to provide an atmosphere of mutual respect, human dignity, patience, and civility. Please let us know if we are not exhibiting these qualities and kindly treat us with the same values. Please mute your cell phone upon entering our office.