OFFICE POLICIES
Physician Orders
A written or electronically placed order from your physician is REQUIRED by law for all imaging exams. Every order must contain five key pieces of information:
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Patient's Name
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Date Ordered (expires after one year)
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Type of Imaging Exam
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Diagnosis or Reason for Exam
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Physician Signature (written or electronic)
If any of these five items are not listed on your order, please contact your physician to prevent delays at check-in on the day of your scheduled exam(s). It is mandatory that you bring the order with you to your appointment or be sure we already have your order as we would possibly need to reschedule your appointment until an order is obtained.
Requirements at Check-In
Please provide your Physician Order, a copy of your current Insurance Card, and a photo ID that also states your name. These are mandatory by law at each appointment and could delay or cancel your appointment if you do not have any of the three.
Payment Policy
Payment is expected at the time of your visit. We will accept cash, check, or credit card. Payment will include any unmet deductible, co-insurance, co-payment amount, or non-covered charges from your insurance company. If you do not have insurance, payment in full is expected at the time of your visit per our Self-Pay Agreement. Any account balance must be resolved prior to any additional services being performed.
You have 60 days to pay any unpaid balance and if not paid in full, your account will be sent to collections. In the event that your account is placed in collection status, you will be obligated to pay the list price (minus any payments made) in addition to a 18% collection fee. In the event of a return check, a $35.00 charge will be assessed.
No-Show Fees
We require a 24-hour notice of cancellation. A “No Show” fee will be charged to the patient for each missed appointment as outlined below:
Fair Oaks Imaging Center: $100.00
Loudoun Imaging Center: $100.00
MRI of Reston: $250.00
PET of Reston: $250.00
Unaccompanied Children or Minors
We respectfully request that you do not bring younger children to an appointment unless another adult is present to care for them. Due to safety regulations, children may not accompany a caretaker into most radiographic exam areas. We cannot provide one of our employees to watch children during your appointment. Siblings are welcome for prenatal ultrasound appointments with an adult chaperone present.
Cell Phone Usage
We kindly request courteous cell phone usage in our waiting areas but NO cell phones in our examination areas. Courteous cell phone usage means volume levels be decreased including video/music playback, calls/conversations be made outside of the waiting room, and being respectful to others.
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