Each patient must have a guarantor who is responsible for timely payment of:
- Fees for service
- Additional fees for forms, returned checks, missed appointments or collection charges.
Read and sign our Financial Agreement & Authorization for Treatment form before services are rendered.
In the case of divorced parents, we cannot become involved in shared payment arrangements. The person who accompanies the child should be prepared and responsible for the necessary payment.
Our billing staff is available to help with questions and problems. Call 212-769-3070.
Patients who reach their 18th birthday are considered adults with regard to their healthcare decisions. Their personal health information becomes protected from their parents regardless of the guarantor/insurance holder.
- If a patient wishes, we will continue to provide care until 21 years of age. After age 21, patients must transfer care to another physician.
- At age 18, we provide a packet that includes a summary of the conditions for care, particularly for those patients living away from home. We require a signed letter agreement from each patient acknowledging acceptance of those conditions along with private contact information.
- Each 18 year old can also sign a Consent to Release Patient Information form and may designate which type of medical information may be shared and with whom. Only with this permission may we discuss the patient's care with parents.
- If you choose not to remain with West End Pediatrics, P.C. after age 18, please arrange for transfer of care to an internist or family physician. Transferred records are maintained for seven years after the last visit, and then are destroyed.