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Financial and Office Policies

Nine Medical Park, Suite 430 
Columbia, SC 29203 
Phone: (803) 765-9435 Fax: (803) 765-2446 

Thank you for choosing Palmetto Allergy & Asthma for the evaluation and treatment of your allergic problems. We look forward to having you as a patient. Please take time to read the following information concerning our office policies. 

Financial and Office Policies: 

  1. On the day of the visit, the patient will be responsible for paying their co-pays and insurance percentages, in addition to any prior balance, before they may be seen. Patients are responsible for any current balance before any services will be rendered, including allergy shots, allergy extract, skin testing, prescription refills, and office visits. As a courtesy to our patients, we offer the convenience of filing insurance for services; however, this is not a guarantee of payment. You are required to pay your deductible and co-payment on the day that the service is rendered. We charge a $15.00 administrative fee for co-pays not paid at time of service. 
  2. At the time of your appointment, we will need to see your insurance card and driver's license. If you do not have your insurance card, you will have to reschedule. 
  3. Managed Care patients are responsible for obtaining their own referrals and authorizations. We will not do same-day authorizations. 
  4. Any minor (under age sixteen) patient must be accompanied by a parent or legal guardian for all office visits. The patient (under age sixteen) cannot be seen without the parent or legal guardian present. A legal guardian must bring their proof of guardianship to the appointment. 
  5. Only one person may accompany each patient to the back for a visit. 
  6. Some of our patients are highly allergic to odors from cosmetic items. In the interest of the health of other patients we cannot allow anyone to remain in the office who is wearing colognes, perfumes, highly scented laundry products, or highly scented personal items such as body lotions, hairsprays, and deodorants. If you are wearing any highly scented products you may be asked to reschedule your appointment. 
  7. There is a $25.00 NO SHOW FEE for follow-up and skin test appointments and a $100.00 NO SHOW FEE for new patient appointments. If these fees are not paid, the patient may not receive allergy shots, skin testing, allergy vaccine, or follow-up visits. If a patient NO SHOWS for more than 2 appointments, the patient will be discharged from the practice. If at any time you feel the need to cancel or reschedule your appointment, please give us at least 48 hours' notice.
  8. Prior to every appointment, the patient will receive a reminder by text or phone call to confirm the appointment.
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In the case that the patient no-shows or cancels, the following procedure will be followed:

  1. 1) Patient will receive a courtesy phone call notifying you about the missed appointment.
  2. 2) Patient will receive a secondary call attempting to place the patient back on the schedule.
  3. 3) Patient will receive a letter via mail or email. Email: 

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By submitting your signature, the parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.

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