Billing and Cancellation Policies


Effective March 1, 2014, our practice joined the Greater Piedmont Medical Association when it merged with Blue Ridge Orthopaedic and Spine Center. Other members include Dominion Internal Medicine and Urological Associates of the Piedmont.

As part of our merger, all billing is handled centrally by Blue Ridge Orthopaedic and Spine Center. Any billing questions should be directed to their billing department at 540-347-2002. Any questions about services performed by us should be directed to our office.

There is a copayment due before each appointment that depends on your health insurance coverage. Click here to see a list of insurances we participate with. To read more about how health insurance coverage works, click here for more information.

Please refer to your health care policy on the exact copayment amounts for a new and a return appointment for a specialist.

We do participate with CareCredit for flexible payment options for hearing aids only (cost can be as low as ~$50 per month over 24 months).


$50 no-show fine for missed appointments
. To avoid a no-show charge, please inform our office of any appointment cancellations at least 24 hours in advance. Same-day cancellations also will be subject to the no-show charge. A missed appointment hurts 3 people. You, the physician, and another patient who could have been scheduled.

Please contact our office for any appointment cancellations 24 hours in advance to avoid the no-show fine!

$100 charge for rescheduling surgery more than 2 times.

Charge for Allergy Injections: $45 for on injection and $57 for 2 or more injections. We will submit to your insurance, as long as it is one we are participating with. If it is not, we ask that you pay promptly for the injections and we will supply you with an itemized statement for you to receive reimbursement. Please be aware that it is our policy that a patient’s account be kept current in order for new vaccine to be made and the allergy injections to continue. It is also our policy to charge your insurance company for the allergy vials ($27 per unit) when they are made and then an administration charge for the injections when they are given.

Botox for Migraine Headaches and TMJ: ($40-$50 per injection to maximum $1000). This service is NOT covered by most health insurance companies. Please call your insurance company to see if this procedure is covered by your plan (CPT is 64613 and 64612; ICD-9 is 346.1 for migraine and 524.60 for TMJ). Payment required before procedure scheduling. The beneficial affects of Botox injection lasts about 3 - 4 months. Financial assistance available for those who qualify. Call 1-800-44-BOTOX, option 6 for more information.

Botox for Cosmetic Uses: (Price as of 9/19/22): $40-$50 per injection). This service is NOT covered by any health insurance company and payment is required prior to any injections performed.

Generally speaking, given this price breakdown, the cost range to treat various wrinkles typically are as follows:

To read more about why the cost variation, click here.

Snoring Procedures: Any type of procedure to address snoring is NOT covered by any health insurance company and payment is required prior to any procedure.

Charge for Providing Copy of a Voice Examination (USB Thumb Drive): $20 if we sell a thumb drive to you. Free if you provide your own.

Voice Examination Including Stroboscopy for Self-Pay Patients: $500

Self-Pay (No Health Insurance) Billing Policy (Download, read, and sign prior to your visit if applicable)

Hospital Charges

Any procedure performed at Fauquier Hospital will involve related hospital charges. As such, a patient who undergoes any procedure in the hospital will receive two billing statements... one from our office for the surgeon's fee and another from Fauquier Hospital for hospital charges. If sedation is performed, there will be another charge from the anesthesiologist.

Please note that our office has NO control over what charges the hospital as well as anesthesia bills for as well as how much they charge. Any complaints these other charges should be directed to their billing department. Again, we have no say, influence, or authority over any charges other than our own. You can reach Fauquier Hospital's finance department at 540-316-2970.

Only for those patients who do NOT have insurance, a discounted price from ONLY our office will be provided.

We should also add that our office receives absolutely NO payments, fees, or kickbacks whether financial or not from the hospital. It would be considered illegal as well (Stark Laws).

On a related note, media has written stories about this situation, especially given how surprisingly high hospital charges can be. Read a story about this issue here as well as here. Read blog article.