Legacy Developmental Pediatrics

Policies and Procedures

Cancellation and No-Show Policy: We understand that you may need to cancel an appointment occasionally. In such circumstances, please contact us no later than 24 hours before your appointment. This allows us to offer your appointment to another patient who may be waiting to see a provider. We understand, however, that emergencies can and do happen, and will make every attempt to work with you. If you can’t contact us 24 hours in advance, please call as soon as you know you cannot make your scheduled appointment time. If you miss your appointment without notice or provide less than 24-hour advance notice, it will be considered a “no-show”. A $40 fee will be charged for a no-show appointment. These fees are the patient’s sole responsibility and must be paid in full before your next appointment and requesting services. Patients who repeatedly no-show may be dismissed from the practice.

Insurance/Copay: Please bring updated insurance and co-payment to every visit. If a referral has not been received by our office, the cash-pay price of $80 for a follow-up visit will be due. We encourage you to verify with our office the week before the scheduled appointment if the referral has been received. Failure to make a co-payment at the time of the visit could result in the cancellation of the scheduled appointment. Patients are responsible for charges not covered by insurance.

Missing proper identification: Patients without a valid photo ID, proper insurance information, or missing insurance information may be asked to reschedule their visit.

Forms/Letters: There will be a $10.00 (less than or equal to 30 minutes) and $20.00 (greater than 30 minutes) charge for filling out forms that require more than a signature, and for writing letters, each time these services are provided. Please allow up to two weeks for completion.

Medical Records: There will be no charge for medical records requests less than 10 pages. Medical record requests of greater than 10 pages will incur a fee. Please allow up to two weeks for completion.

Phone Calls: Extended phone consults (longer than 10 minutes) may be billed a telephone consultation fee from $10.00 to $35.00.

Messaging (Phone, Text, Portal): Your messages are very important to us. Providers will respond to all messages within 3 business days of your request.

Late policy: Being 15 minutes late for an appointment may require you to either reschedule or wait for an available opening. There are no guarantees since openings due to cancellations or no-shows are unpredictable.