13132 Newport Ave #100  Tustin, CA   92780               Phone (714) 565-7960     Fax (714) 565-7982
Pediatric & Adult
Medicine,Inc.
Accounts:
All co-payments are due and payable at the time our services are rendered.  We do not bill for
co-payments. If your copay is not paid at the time of service, there is a $10.00 billing fee.  Statements
are sent out on a monthly basis, and bills are considered delinquent 30 days after charges were
incurred, or 30 days after your insurance has processed your claim.  Accounts over 120 days may be
sent to a collection agency.  Patients who repeatedly write Not Sufficient Funds (NSF) checks or
whose accounts have been turned over to a collection agency will be asked to leave the practice.

Insurance:
When applicable, our office will be happy to bill your primary insurance company on your behalf.   If
you have any additional insurance coverage, we will provide the necessary documentation for you to
submit a claim. We do not routinely provide end-of-the-year statements for tax purposes.  We ask that
you maintain accurate financial records as you access our office for medical care.

Please be advised that parents are responsible for knowing precisely what their insurance coverage
is (e.g., regarding well baby visit and immunization benefits vs. sick visits) and whether our office is
listed as Preferred Providers under your insurance plan.   If you are uncertain, please contact your
insurance company for clarification.  All services not covered by your plan will be billed directly to you.
Please bring your current insurance card with you to each visit.  All co-payments are payable at the
time you register at the front desk.  

HMO plans:
We are currently participating primary care providers for SJHAP IPA (St. Joseph Hospital Affiliated
Physicians), Monarch IPA, Prospect IPA, and CHOC Health Network.

PPO plans:
We are currently participating primary care providers for all major PPO plans.   Please verify our level of
participation and your particular benefit coverage, with your insurance company as coverage may vary with
each health plan, your particular and your type of policy (individual, small group, group, etc.)