Office Policies

Financial and Payment Policy

Effective January 1, 2025 (official Unified Policy)

Draft. This page contains placeholder content awaiting formal review by Crown Valley Imaging's legal counsel. Do not rely on it as official policy until this notice is removed.

This policy explains patient financial responsibility, insurance billing, payments, refunds, and fees. The signed Unified Policy PDF on this page is the authoritative document.

Patient responsibility

Provide accurate insurance and demographic information and pay all co-pays, co-insurance, deductibles, and balances not paid by insurance.

Insurance billing

CVI may bill your insurer as a courtesy; coverage is not guaranteed. You are responsible for all charges not paid by your insurer.

Payment authorization

By paying through the patient portal or storing a card, you authorize CVI and its processor to charge that card for balances due, including after insurance adjudication.

Refunds

Refunds are granted only for verified overpayments, duplicate charges, or unauthorized transactions, and are issued to the original payment method whenever possible.

Chargebacks

Please contact CVI first to resolve any dispute before initiating a chargeback. Unwarranted chargebacks may result in recovery of related administrative costs (up to $35 per occurrence).

Credit card surcharge

Credit card payments to Crown Valley Imaging, LLC / Crown Valley Radiologists, Inc., APMC carry a 3.5% surcharge. The surcharge applies only to credit card transactions and is disclosed before you complete payment. To avoid the surcharge, pay by cash, check, or debit.

Returned or failed payments

Returned ACH or check payments may incur a $25 fee. CVI may reattempt failed payments.

No-show and late-cancellation fees

Fees apply if you fail to cancel at least 24 hours in advance: $50 per missed X-Ray or DEXA appointment; $75 per missed CT or Ultrasound appointment; $100 per missed MRI appointment.

Good Faith Estimates

Upon request or as required by law, CVI provides Good Faith Estimates for self-pay or uninsured patients. Request one on our Insurance & Payment page, by emailing billing@cvimaging.net, or by calling (949) 215-3304.

Collections

Delinquent accounts may be referred to collections consistent with law. Required notices will be provided before any adverse credit reporting.

Billing questions

Contact our billing team at (949) 215-3304 or billing@cvimaging.net.

Questions about this policy? Email support@cvimaging.net or call 949-367-1010.

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