Red Hills Surgical Center 


Manual:    3 Administration 
Policy No.  3.5  Title:  Payment Plan Policy 
Effective Date: 4/2015 Review Dates: 
Revision Dates:  Archive Date:



When a patient has no method of paying in full the copay, co-insurance and/or deductible due at the time of service, payment arrangements may be offered and a promissory note created.  The following payment plans may be offered.

  1. 50% at the time of admission and the remaining 50% due in 30 days.
  2. 50% at time of admission, 25% due in thirty days (30) and the remaining 25% due in sixty (60) days.
  3. 33% at time of admission, 33% due in thirty days (30), and the final balance due in sixty (60) days.

It should be explained and stressed to the patient that the payment plan is available only if all payments are made on time.  If a payment is more than 10 days late, the entire balance becomes due and payable.  The full balance will be due in 10 days.

If these proposals are not acceptable any other arrangement, longer than 60 days, must be approved by management.

We only offer payment plans through Zirmed, our payment processor. Payment plans can only be arranged via auto draft (either ACH or debit/credit card). If the patient is unwilling to provide the necessary information to set up an auto draft, then they must pay in full on or before date of service. Once the necessary information has been entered into Zirmed, we will destroy all documentation regarding the patient’s bank and credit/debit accounts. We do not keep patient banking information on file.