As a patient of Menlo Medical Clinic you will be required to sign a financial responsibility and authorization for treatment form. 

On occasion your insurance may determine the care you have received is NOT a covered benefit.  Please read your insurance handbook and be aware of what your insurance offers for benefits.  When in doubt contact your insurance company directly for clarification.  You will be responsible for care not covered by your insurance plan.

• Not a Covered Benefit – is not covered or only partially covered by your insurance plan, also excluded may be work injury or auto accidents.
• Not deemed medically necessary – not provided as the result of illness or injury.
• Before or after Eligibility – services provided during a period your policy is not in effect.

Co-pay Requirements

It is the policy of the Menlo Medical Clinic that patients are prepared to pay their required copayment at the time service is rendered.

Self-Pay Patients

All Self-Pay patients and patients who present without proof of insurance are required to make a deposit of $100.00 at the time service is rendered.

Forms of Payment

We accept Cash, Checks, Visa, MasterCard and American Express. 

For your convenience we have an ATM located on the first floor of the clinic to the right of the elevators.