Patient Information

Primary Care Referrals

If your insurance carrier requires a referral from your primary care physician, please send your completed referral forms to us prior to your appointment. Patients cannot be seen without the appropriate referral.

Co-Payments

Co-payments and deductibles are due at the time of your scheduled appointment. Please plan to pay for non-covered services (prolotherapy, acupuncture, supplies, and equipment) at the time of treatment.

Methods of Payment

Premier Pain Centers accepts checks, and the following credit cards: Visa, Discover, and MasterCard. We do not accept cash payments for medical services or co-payments.

Delays

Please call if you are running late. Medical evaluations and treatments may be shortened for patients arriving 10 to 15 minutes late, but patients arriving more than 15 minutes late may be asked to reschedule. If our office is responsible for a delay, your session will be completed in its entirety.

Cancellations

If you are unable to keep an appointment, please contact the office at least 24 business hours prior to your scheduled appointment time.

Repeated Missed Appointments

Although circumstances sometimes prevent timely notice of cancellation, we reserve the right to refuse an appointment to someone who has an established pattern of missing appointments without providing us with appropriate notice.

Medication Renewal

Please contact your pharmacy directly, or submit your request online using the Patient Portal. Please submit any request no fewer than three (3) business days before your medication runs out. Once your provider has authorized your prescription refill request, it will be completed.

Miscellaneous Charges

Returned Check Fee:

A returned check fee of $35 will be collected for any check returned to us unpaid.

Missed Appointments or Cancellations with less than 24 business hours notice:

A fee of $75 will be collected in order to discourage future missed appointments or cancellations within 24 hours of your appointment.

Prescription refill prior to scheduled appointment:

A $15 fee will be collected to cover the cost of processing the refill request prior to your next scheduled appointment.

Monthly Service Fee on balances more than 30 days past due:

1.5% of the total balance will be added each month the balance is left unpaid. Balances referred to collection agencies are subject to additional fees. In addition, patients whose accounts have been referred to collection agencies must pay any outstanding balance due and pay for each subsequent visit in full at the time of the appointment before additional services/care will be provided.