Eastbrook Family Health Center
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Thank you for choosing Eastbrook Family Health Center as your health care provider. We are committed to providing you with the best possible care and would be happy to discuss our professional fee with you at any time. Your clear understanding of our financial policy is important to our professional relationship. Please ask if you have any questions about or fees, financial policies, or your financial responsibility.

Patient Responsibility

Payment for service is due upon time of service. This includes all deductibles, co-insurance and co-pays. It is important to understand that not all services are covered by your insurance. You the patient are ultimately responsible for payment of any service not covered by your insurance.

  • Copayments are required at the time of service. If your copays are not paid at the time of visit, there may be an additional billing charge of $10.00 added to your account.

  • Patients responsible for paying their full bill may receive a prompt pay discount if the entire bill is paid at time of service. This discount does not apply to partial payments or Co-payments. It only applies to all charges paid in full at time of service.

  • All financial statements will come from PAL (Physicians Alliance LTD). Payments should be mailed to PAL, PO Box 729, East Petersburg, PA 17520. You can also reach PAL at 717-519-0753 with any questions regarding your statement. If payment or payment arrangements are not made within 70 days from the service date your account will be considered pre-collections status. One reminder will be sent and if no response PAL will place your account to collections.

Collection Costs

  • Payment for services is due upon receipt of the service, and in any case within 30 days of the date of our statement of services. If any bill is not paid within 30 days of this date, interest will be charged on the unpaid amount at the rate of 1.5% per month (18% per annum), and the patient will be responsible for all collection fees charged to PAL by any third party, including attorney costs.

  • Return checks will result in a $25.00 service charge. The check amount and any service fees must be paid within 10 days of notification. Failure to pay in full in 10 days may result in your account being forwarded to collections.

Potential Fees

Missed Appointments and Late Cancellations fees. We would appreciate a two hour notice if you need to cancel an appointment. If you cancel your appointment with less than two hour notice (certain specialists require an eight hour notice) you may be charged a late cancel fee. If you miss a scheduled appointment without cancelling or re-scheduling you may be charged a No-Show fee.

Certain miscellaneous fees may be charged including prescription refills made outside of appointment, forms needed not provided at visit, medical record copies, Etc. Please inquire if any fees will be due for miscellaneous services before requesting service.

Telephone Calls

In order for us to service your account or to collect any amounts you may owe, we may contact you by telephone at any telephone number associated with your account, including wireless telephone numbers, which could result in charges to you. We may also contact you by sending text messages or e-mails, using any e-mail address you provided to us. Methods of contact may include using pre-recorded/artificial voice messages and/or use of an automatic dialing device, as applicable.


Eastbrook Family Health Center  ~  29 Eastbrook Road, Ronks, PA 17572  ~  Tel. (717) 299-5711   Toll Free 1-866-285-2002  Fax (717) 299-0283
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