We at St. Michael Medical Clinic are dedicated to providing the best possible medical care and service to you and your family. Your understanding of our financial responsibility policy is an essential element of your care and service. This will prevent any misunderstandings and allow us to serve you better. If you have any questions, please call our office.


   1)   You are ultimately responsible for knowing what your plan does and does not cover and the administrative rules.  (i.e. in-network / out-network; out-of-pocket balance, copayment, coinsurance, deductible , Health-Saving-Account balance; Labs/Radiology/EKG; authorizations and referrals)

2)   You are encouraged to verify specific LABs/other procedures covered and not covered.

What is covered: portion 100%, 80%, 20%, other; preventatives benefits & screening; EKG/XRay/MRI/CT radiology test; mental health office visit; consult/specialist evaluation.

3)  As a courtesy, we will verify your insurance eligibility and benefits.  However, we cannot guarantee that the information received, is accurate due to insurance policy changes and real-time/up-to-date system information.    We will bill your insurance company with whom we have a contract agreement with.

4)    Once your benefits have been determined, payments of any copays, coinsurance, deductible, and fees are required at time services are rendered.

5)    Once your insurance company has processed a claim, any balance as determined by your insurance plan to be “patient’s responsibility” and/or “non-covered service”, will be your responsibility.

6)  If you disagree with the “patient responsibility” amounts due to our office per your insurance’s Explanation-of-Benefits(EOB),  please immediately call  your insurance company and our office for further explanation. 

7)  Failure to provide current insurance information to our office and/or reply back to insurance’s request for additional information may result in the entire bill being your responsibility.

8)    SELF-PAY patient: Full payment for your visit is expected on the day of the visit.

9)    Any outstanding balance owe to our office is also due, unless payment arrangements have been made in advance with our office.

10)  The independent labs, Quest Diagnostics or LabCorp, will also bill independently. If you receive a bill from the lab, you will need to contact the lab for further detail and payment arrangement.

11)  There will be a fee for ALL forms to be filled out and/or typed letters requiring a signature from our physicians, nurse practitioners or medical staff.    There is a charge for re-writing lost prescriptions.

12)   Our office DOES NOT bill third parties (i.e. automobile insurance).  Your visit will be SELF-PAY and a receipt will be given to you to file with your auto-insurance.   Our office DOES NOT accept workman’s compensation cases.

13)   Please notify us in advance, if you cannot make your appointment.  We reserve the right to ask you to seek care from another physician, if you miss three appointments without notification.    If you are more than 30 minutes late for your appointment, you may be asked to reschedule.

14)    We accept Visa, MasterCard, Discover, cash and check.  RETURNED CHECKS will incur a $25 fee.


  • For medication refills, please call the pharmacy and speak to a technician/person.
  • Allow at least one week left of medication when calling pharmacy for refill.
  • Allow at least 48 hours to process requests, once we receive the request from the pharmacy.
  • Refills will not be performed as an “emergency”.  Please plan ahead.
  • Patient is responsible for keeping track of the amount remaining and for taking the medication in the dose prescribed.
  • No Refills will be made during weekends or holidays.

*** Some medications require closer monitoring than others.  A general outline is as follows:***

  • Mental Health Medications require an appointment every 1-3 months based on individual assessment.
  • Narcotics require an appointment for every refill.  THERE IS NO EXCEPTIONS
  • Triplicate prescriptions require an appointment every 3 months (or sooner if changes are needed)
  • All other maintenance medications require a 3-6 month follow-up appointment for consideration on therapeutic regimen and necessary blood-work.

It is per the discretion of the physician if an appointment will be required before a refill is granted.  Many factors and circumstances are considered before a final decision is made.            Thank you.

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