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Office Policies

Appointment Policies/Fees for Services (Updated 4/5/22)

Scheduled Appointments

Well-child visits, follow-up appointments and consultations can be scheduled in advance of the appointment date. Same-day appointments should be made after speaking with our receptionists or nursing staff. Late arrivals will be seen as time permits, but in some circumstances, it may be necessary to reschedule the appointment.

Telehealth Visits

Telehealth visits work best for medical problems that don’t require a physical exam. Rashes, mild upper respiratory infections, conjunctivitis (pink eye), constipation and allergy symptoms fall into this category. Likewise, management of long-term medications used to treat ADHD, seasonal allergy and oral contraceptives can often be managed without an office visit.

Telehealth appointments are billed the same way as in-person visits. As such, co-pays, deductibles and other charges apply to telehealth visits in the same manner as in-person visits. Coverage varies between insurance companies, so it’s important you’re informed regarding the services and limitations of your insurance plan.

After Hours Medical Advice

There will be a minimum $25 charge for after-hours routine medical care provided by the on-call doctor. If the problem is more complex, you may be billed as a telehealth visit.

Medical Advice Provided by Email

There will be a $25 charge for medical advice provided by email.


Co-pays, deductibles and account balances are due at the time of the visit. We accept checks, MasterCard, VISA, American Express and ApplePay. If we don’t participate with your insurance plan or you don’t have health insurance, payment in full is expected at the time of service.

Cancelled Appointments

We require a 24-hour notice for canceling any appointment. There is a $50 charge for missed appointments. This includes not showing up for the visit or late cancellations. If your child gets sick Sunday for a Monday appointment, the fee will be waived as long as you call the office. 

Walk-In Appointments

As a matter of policy, we discourage walk-in visits. If you show up without an appointment, your child will be seen as time permits, but there will be an additional $50 charge for the visit.


If your child needs school, camp or sports physical forms, let the receptionists or nursing staff know at the time of check-in. Expect a 3- to 5-day turnaround time. There is a $25 charge per form. The completed forms will be sent to you via email, and you will be billed at that time. If a form is needed sooner than 24 hours, there will be an additional rush-fee of $15.

Prescription Refills

If you call or email the office for a prescription refill, we may require that you schedule an in-person or telehealth visit. If we’re able to refill the prescription without a visit, allow 3 to 5 days for the prescription refill to be completed. There may be a charge for this service.


Patients often request letters to get coverage for medical conditions/procedures, to receive accommodations for their child at school and other situations. The minimum charge for this service is $25.

Transferring Medical Records

There is a $25 charge per child to copy or transfer medical records. These charges must be paid in full before the medical record will be copied and available for transfer or pick up.

Covid-19 Fees

There is a $50 charge for obtaining and processing Covid-19 swabs on parents and children. If your child is being seen for a sick visit, this fee will be waived.

Health Insurance

Medical insurance is a contract between you and your insurance company. Therefore, it’s your responsibility to know the limits and benefits of your policy. Please check with your insurance plan before scheduling an annual well-child exam. Each plan varies with respect to the allowable interval between well visits, so you need to know your plan benefits. If the visit is not covered, you will be responsible for payment. 

When arriving at the office, please present your current insurance card. This verifies that you are an active member with the insurance company. If your contract with the company is invalid, you will be responsible for any charges incurred at that visit. Please notify us of any changes to your insurance coverage.

Due to differences in policies, it’s your responsibility to check your insurance plan to be sure they consider us as participating providers. We accept with the following insurance carriers:

 United Healthcare

  • United Healthcare Choice
  • United Healthcare Choice Plus
  • United Healthcare Core Choice Plus
  • United Healthcare Options PPO


  • Cigna PPO
  • Cigna Open Access Plus

Denied Coverage for Services

If your insurance company denies payment for services rendered for any reason, we will bill you directly. Your insurance company may reimburse only part of your claim if:

  • You haven’t met your deductible.
  • Our fees are above their customary rate.
  • Your policy doesn’t cover the service rendered.
  • Your child is not covered at the time of service.

Outstanding Balances

Patients with an outstanding balance of more than 60 (sixty) days must make payment arrangements prior to scheduling future appointments.

Returned Checks

A $25 charge, plus any bank fees incurred, will be charged for returned checks. 

Billing Office

Contact the office at 202-363-6150 or email billing@chevychasepediatrics.net with questions regarding billing.

 All fees are subject to change.

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