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Office Policies


Our goal is to provide and maintain a good physician-patient relationship. Letting you know in advance of our office policy allows for a good flow of communication and enables us to achieve our goal. Please read this carefully and if you have any questions, please do not hesitate to ask a member of our staff.

(As a courtesy, Dr. DIAZ PEDIATRICS bills your health insurance on your behalf.)

  • Co-payments, Co-Insurance, Deductibles and Non-Covered services are due at the time of service.
  • Self-Pay patients are expected to pay for services in FULL at the time of the visit.
  • If we do not participate in your insurance plan, payment in full is expected from you at the time of your visit. We will supply you with an invoice that you can submit to your insurance for reimbursement.
  • Patient Balances are billed immediately on receipt of your  insurance plan. Your remittance is due within 10 business days of your receipt of your bill.
  • If previous arrangements have not been made with our finance office, any account balance outstanding longer than 28 days will be charged a $20 re-bill fee for each 28-day cycle. Any balance outstanding longer than 90 days will be forwarded to a collection agency.


  • Understand your benefit plan.
  • Bring your insurance ID card to every appointment
  • Advise the staff of any changes in address, telephone numbers and insurance coverage.
  • If you are a member of an HMO, choose one of our doctors as your primary care physician.


(fees are subject to change)

Copies of medical records $1/page
Completion of additional school physical forms, e.g. blue/yellow forms  (1st set free) $5.00/each
Special request physician letters $25.00
Returned check (for insufficient funds) $25.00


  • We require 48 hours‘ notice for non-emergent referrals and for monthly medication refills. It is your responsibility to know if a selected specialist participates in your plan.


In an effort to help us stay on time and minimize your waiting time, we have adopted the following office policies:

  • Presenting late for any appointment by 15 minutes or more may necessitate in rescheduling your appointment. Call us if you’re running late. We can assess at that time whether or not you may need to reschedule.
  • We discourage you from adding a sibling to our schedule at the time of check-in. We would request that if you would like more than one child to be seen that you inform us when you make your initial appointment. This allows us to book enough time to see multiple siblings of the same family and not increase waiting time for patients who follow your appointment.
  • Walk-ins are also discouraged. Please call ahead. There is no guarantee that we can see your child immediately if you present without calling first. In fairness to other patients who have booked an appointment, and if you have no life-threatening emergency, you may be asked to reschedule for an available appointment slot later in the day or the following