Setting up your first visit at COPA is important. We’ll need to know your child and family’s medical history and verify your health insurance information. Plan ahead and download the forms before your visit.

New Patient Forms

 

Complete the new patient forms as well as an authorization to transfer records from another doctors office.

New Patient Form - English
New Patient Form - Spanish
HIPAA form
Records release authorization

Prescription refill

 

Insurance (New or Change)

As a courtesy, COPA will submit claims to all insurance carriers if we have received proper verification of insurance coverage at the time of each visit. We bill insurance as a courtesy. However, you are ultimately responsible for all charges. Within 60 days of the visit, a payment (by you or your insurance company) must be made on your account to remain in good standing with our office. Please remember that insurance companies often deny claims based on the coverage your policy provides or deductibles that have not been met. If you have any concerns regarding your coverage or insurance payment, please contact your insurance carrier.

Insurance plans accepted/not accepted

No-show fees

We encourage all patients to keep their appointment whenever possible. With the overwhelming demand for pediatric services in our community, this allows us to help as may children as possible everyday. For this reason we charge a $20.00 "no show" fee if your appointment is not canceled or rescheduled with at least 1 hour notification. Continued "no shows" may result in your family being discharged from our practice.

Billing

Co-payments and deductibles are due at the time of service. You may receive a balance due statement from COPA after we have received payment from your insurance company or if you have no insurance. It is our expectation that you will pay the balance due within 30 days. We accept cash, local checks, debit cards and credit cards; including VISA and MasterCard. If payment in full is not possible, please contact our billing office at: 541-389-3905.

Appointment times

The physicians make every effort to see you at your appointment time. Occasionally, unforeseen circumstances may cause them to be delayed or called away from the office. We hope that you will understand and realize that if your child has an emergency, the physicians will drop everything to attend to them. Please make every effort to arrive for your appointment at the scheduled time. This allows us the best opportunity to see everyone at the correct time and avoids the possibility of us having to reschedule your appointment.

 

Our office staff is ready to answer specific questions on weekdays between 8:00 am and 5:00 pm.

 

 

 


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What do you think?

As the premier pediatric practice in Central Oregon, COPA constantly strives to improve and exceed the expectations of the families we serve. Any feedback on those things we are doing well or on ways we can improve our service is greatly appreciated.

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