Co-pays and Deductibles
Balances are to be paid at the time of service regardless of who accompanies the child to the appointment. This includes any and all co-pays and deductibles. Patients may not be scheduled or seen for an appointment until payment has been received. Balances in arrearage of 30+ days will be reported to all major credit bureaus. If payment arrangements have been made with Country Creek Pediatrics, it is a courtesy; payment is expected as agreed.
No Call, No Show
If you are unable to keep a scheduled appointment, please call the office a minimum of 24 hours ahead to cancel or reschedule that appointment. You must speak with a live operator after pressing Option 2 or your appointment will not be cancelled. You may also send a message via your Patient Portal account. Failure to cancel your appointment without 24 hours notice will result in a $25 fee.
We are happy to complete any forms needed for school, camp, sports or other activities. Please bring the form with you to your check-up and we will complete them and return them to you at the end of your visit for no additional charge. If the patient has a current Annual Well Exam on file, the form can be submitted to our office via mail, fax or dropped off in person. Due to the high volume of forms we receive, please allow 48 hours from time of receipt to return the form to you. Please read all forms before submitting them to be sure your child has had an exam within the required time. We will not falsify dates. All portions of the parent and student sections must be filled out completely by the parent and/or patient before a provider will fill out any form. All forms need to include instructions as to where to send the forms once completed, along with a self-addressed stamped envelope if they are to be mailed. We do not email forms.
If transferring to our office from another practice - welcome! Please request the records be either be released directly to you or faxed directly to us at 248.475.5632. We request that we receive the records from your previous provider before scheduling an appointment in our office.
If transferring out of our office, complete and submit our “Authorization to Release Medical Records” form. The form must be signed by the parent or legal guardian. We do not mail records. There is a $30 fee for the copying and releasing of medical records directly to patients that is due upon submission of the request.
All visits in our office are by appointment only. If you need to be seen by one of our Providers, please call the office and we will make our best effort to see you in a timely fashion. We are unable to accommodate patients that walk-in the office without an appointment at that time, but will assess the situation and give an appropriate appointment.