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Financial Policy


It is the philosophy of Physicians & Surgeons for Women that all patients receive the best possible care and service. Therefore, your complete understanding of our financial policy as it relates to your financial obligations is an essential part of our philosophy. Please read this thoroughly.

Many changes have taken place in the health insurance industry in recent years. Services once covered in full are now partially covered, covered only under certain circumstances, or in some cases not covered at all. It is your responsibility to know your plan benefits, please check with your insurance company regarding possible coverage exclusions.

Payment for all services provided by our practice are due in full at the time the services are rendered. Exclusions to this policy are those patients with insurance, Medicare, Medicaid or confirmed Worker’s Compensation patients. Payment Plans are available for all Surgery or OB Patients prior to delivery or surgery. You will be billed in full for any services that your health plan deems to be a non-covered service or any balance due after we have received payment from your insurance carrier. All patient balances are payable upon receipt of the statement.

It is our policy that any patient over the age of eighteen will be financially responsible for all charges incurred. For any patient under the age of eighteen, the parent who accompanies the minor for their visit will be financially responsible for all charges incurred.

A $35 Returned Check Fee will be assessed to the account for every check returned for insufficient funds.

A small processing fee will be added on all credit card/debit card payments.


Good Faith Estimate

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any nonemergency items or services. This includes related costs like physician charges, medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one (1) business day before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
  • Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit or call 1-800-985-3059


Physicians and Surgeons for Women
1821 E High St
Springfield, OH 45505
Phone: 937-323-7340
Fax: 937-323-3363

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