RESOURCES

NEW PATIENT FORMS

This form collects all the necessary personal information for new patients.

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OTHER FORMS

This form authorizes our office to release your medical records.

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BILLING & INSURANCE


We are doing everything possible to hold down the cost of medical care, and we agree to provide quality medical care at a fair and reasonable price. You can help a great deal by eliminating the need for us to bill you and by understanding the benefits of your insurance. The following is a summary of our payment policy.

PAYMENT IS EXPECTED AT TIME OF SERVICE:
Payment is required at the time services are rendered, unless other arrangements have been made in advance. This includes applicable co-insurance, co-payments and outstanding account balances. Reston Pediatrics Associates Physicians accept cash, personal checks, and VISA, MasterCard, American Express and Discover cards. There is a service charge for all returned checks.

If you receive more than one type of service on the same day, you may be responsible for more than one co-pay or the balance for the additional service, depending on your insurance plan (i.e.: well exam and a routine/ sick visit). Any amount not covered by the insured/ patients insurance is due upon receipt of the bill. Failure to pay balances may result in discharge from the practice.

Patients with an outstanding balance of $100 or are 45 days overdue must make arrangements for payment prior to scheduling appointments.

MEDICAID PATIENTS We are not contracted with Medicaid and CANNOT see patients that have Medicaid. If you have Medicaid or plan to apply for Medicaid, you will need to find a provider that accepts Medicaid insurance.

SELF-PAY PATIENTS
We will give you an estimate of the cost of the visit and payment is due at the time of service. Please see the Front Desk staff when checking out.

Our billing representatives are available to discuss payment arrangements with you,
Monday-Friday between 8.00am and 4.00 pm, at 703-450-8660, ext 2001.


HELPFUL LINKS


Immunization Information from American Academy of Pediatrics

Immunization Information from
American Academy of Pediatrics

Consumer Product Safety Commision

Consumer Product
Safety Commision

National Highway TrafficSafety Administration

National Highway Traffic
Safety Administration

Virginia Department of Health

Virginia Department
of Health

Centers for Disease Control and Prevention

Centers for Disease Control
and Prevention

Healthy Children

Healthy Children

Allergy & Asthma Network / Mothers of Asthmatics

Allergy & Asthma Network /
Mothers of Asthmatics

Overpayments, credits, and unapplied credits on a patient account will be refunded upon written request to Reston Pediatric Associates from the responsible party within 30 days.

WE LOOK FORWARD TO MEETING YOU

VISIT US AT OUR NEW LOCATION



GET IN TOUCH WITH US TODAY


Please call or email us to schedule your meet & greet!

This form is for NON-MEDICAL communications only! If you have a question regarding your medical care, please call our office.


LANDSDOWNE


703-450-8660
703-404-0286

44160 Scholar Plaza Suite 450, Lansdowne, Virginia 20176

IF THIS IS AN EMERGENCY, PLEASE CALL 911 IMMEDIATELY!