Office Policies


Western Michigan Pediatrics, PC will adhere to insurance carrier’s policies regarding the payment of copays at the time of service.

If a patient/parent does not pay their copay at the time of service, we will send them a statement for a fee of $10. If the copay is not paid at the time service is provided, but is received by the end of the day, the fee may be waived.

This fee will not apply if a patient pays their copay, but upon processing the claim, the insurance company applies the charge to a deductible or they deduct a co-insurance amount.

All self pay patients, as well as patients with whom we do not participate with their insurance, are also expected to pay at the time of service. We have the option to courtesy bill some of the plans on their behalf.


Western Michigan Pediatrics, P. C., is dedicated to providing excellent patient care. Appointments that are missed hinder our ability to provide the highest quality of care possible.

If a patient is unable to keep an appointment, they are asked to contact the office, 24 hours prior to the appointment time. If an appointment is not kept, or not cancelled, it will be considered a “NO SHOW”.

You will be charged a fee of $50 for a missed Well Child Exam Appointment, and a fee of $25 for all other types of appointments.

As a courtesy, our office will attempt to contact the patient/parent of their appointment the day prior. However, if we are unable to make contact, it is still the obligation of the patient/parent to keep or cancel the appointment.


You may call the office during normal business hours or after hours and leave a request for a prescription refill on our Prescription Renewal Line. Please allow 24 hours for your request to be filled.

MOST prescriptions are now sent electronically to the pharmacy including ADD and ADHD medications.

When leaving a prescription refill request, make sure you leave ALL of the following information:

  • Your name and relationship to the patient as well as a contact number for you if there are any questions
  • The patient’s date of birth
  • The name and dosage of the medication
  • How often it is taken?
  • The name, address and phone number of the pharmacy

Click here to view our Notice of Privacy.

Click here to view our HIPAA Disclosure.


Western Michigan Pediatrics will charge a $20 fee per patient for the copying and transfer of medical records. We do offer a limited record to be copied, for no fee, which consists of the Last Well Child Exam, Immunization Record and Problem list.

This fee is payable prior to records being sent.

Click here to download our medical records release form

If you would like records to be sent to us, please click here to download a form to complete and give to your current provider


Hello visits are opportunities for parents and families to meet our providers and staff and to learn about our office. Please call to schedule a visit.


Hospital Visits are provided to all of our hospital patients, including Newborns by Helen DeVos Children’s Hospitalists. These are physicians who specialize hospital care.


We participate with numerous insurance companies. At each visit, you will receive a statement of services provided. We request payment of copays and your responsibility of your bill at the time of service. Statements are sent out for uncompensated charges.

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