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Dr. Wasim Haque
V. Jane Zepeda, PA-C
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Financial Policy
Thank you for choosing us as your Endocrinologist. The following is our financial policy. Our main concern is that you receive the proper and optimal treatments needed to restore your health. Therefore, if you have any questions or concerns about our payment policies, please do not hesitate to ask our office manager.

We ask that all of our patients read and sign our financial policy as well as complete our patient information form prior to seeing the doctor.

Payment for services is due at the time services are rendered. We accept cash, checks, and for your convenience, Master Card, Visa, Discover, and American Express. We will be happy to process your insurance claim for you.

In special instances, we may accept assignment of insurance benefits. However you must understand that:

1. Your insurance policy has a contract between you, your employer and the insurance company. OUR RELATIONSHIP IS WITH YOU, NOT YOUR INSURANCE COMPANY.

2. ALL CHARGES ARE YOUR RESPOSIBILITY WHETHER YOUR INSURANCE COMPANY PAYS OR NOT. Not all services are a covered benefit in all contracts. Some insurance companies arbitrarily select certain services they will not cover. You may receive a separate bill for any lab, x-ray or diagnostic procedures done in our office that are not covered by your insurance company.

3. Fees for theses services, along with unpaid deductibles and co-payments are due at the time of treatment.

4. If the insurance company does not pay your balance in full within 30 days, we ask that you contact the carrier to help speed things up.

5. IF THE INSURANCE COMPANY DOES NOT PAY YOUR BALANCE IN FULL WITHIN 45 DAYS, WE REQUIRE THAT YOU PAY THE BALANCE DUE WITH CASH, CHECK OR CREDIT CARD.

6. Returned checks will be subject to a $25 service charge.

7. Please note that, unless cancelled at least 24 hours in advance, you may be charged for missed appointments at the rate of a normal office visit. Please call if you have to reschedule. We understand that temporary financial problems may affect timely payment of your balance. We encourage you to communicate any such problems so that we can assist you in the management of you account.

Again thank you for choosing us as your Endocrinologist. We appreciate your trust in us and we appreciate the opportunity to serve you.