Notification of Insurance Changes/Renewal Policy
EBS Children’s Institute of Oxford (EBS) must have current information on file regarding Insurance at all times. It is the responsibility of the parent/guardian to know of any and all changes that may occur in your insurance policy. It is also the responsibility of the parent/guardian to be sure that EBS is aware of any and all changes to the policy at or before the time that they go into effect.
Please note: Many insurance policies change in January each year; however, they can change at
*Notification of Change: All changes must be directed to the Clinic Administration Staff and appropriate insurance card and identification provided.
All co-pays must be PAID AT TIME OF SERVICE. We can offer to have a credit card on file for your co-pays if you prefer.
We thank you in advance for your cooperation and invite you to call the clinic at 662-380-5170 with any questions that you may have about billing.
I have read and agree to my financial responsibility for the services provided to me by EBS Children’s Institute of Oxford. This also certifies that the information I have provided to EBS Children’s Institute of Oxford, to the best of my knowledge, is true and accurate. I authorize my insurance carrier to pay EBS Children’s Institute of Oxford the full and entire amount of the bill incurred by my child.