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Patient Financial Responsibilities


We want to make sure our patients are well informed of their responsibilities when they decide to get healthcare services from any healthcare provider. We are not the exception.

A patient (or a patient’s guardian, if the patient is minor) is the ultimate responsible person for the payment of treatment and care. It is important that each patient or guardian gets updated information about their insurance and will be responsible for any charges incurred if the information provided is not corrected or updated.

Patients are responsible for the payment of copays, coinsurance, deductibles and all other procedures or treatments not covered by their insurance plan. An insurance policy is a contract between your insurance company and yourself.

Payments are due at the time of service, or before major treatment plans such a surgical procedure. For your convenience we accept cash, check, money orders, and major credit cards at our office.

Patients may incur and are responsible for the payment of additional charges that are not covered by insurance companies, as records request or any other service or product connected to their care.

There are additional charges that we may include in your bill. These charges may include but are not limited to:

A $45 dollars charge for returned checks

A $50 dollars charge, for missed appointments without 24 hours advance notice

A $150 dollars charge, for extensive phone consultations and/or after-hours phone calls, requiring diagnosis, treatment, or prescriptions. (only for those patients that didn’t have a major surgery procedure)

A $35-$50 dollars charge, for the copying and distribution of patient medical records

An extra $15 dollars charge, for extensive forms completion

Charge for any cost associated with collection of patient balances.


If you find that your visit to our office will be extended, don’t worry you do not have to pay for parking. We have an open parking with several spaces for your convenience.

You can drop off in front of our building in case of bad weather conditions.

Our office is located on the third floor of the Katy Medical Arts Center. There are two elevators for your convenience. Please read the instructions to enter the facility.

Our office doors are locked as a measure of safety during COVID-19 pandemic. Please read the sign at the door upon your arrival.


Jaime Roman-Pavajeau, MD, PA
1331 West Grand Parkway North, Suite 330
Katy, TX 77493
Phone: 281-318-6770
Fax: 281-693-5459

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