1. It is the policy of this office that all services rendered are charged directly to you, the patient, and that ultimately, the patient is responsible for all services, including those not reimbursed by third party payors.
2. All payments are expected at the time of service, or at the beginning of each week. For patients seen more than once per week, we accept payment at the beginning or end of each week, and not at each visit.
3. All insurance assignment patients must pay their deductibles in full and the co-payment at the time of service, or at the end of each week.
4. Returned checks and balances over 30 days may be subject to additional collection fees and interest charges of 1.5% per month. Charges may also be made for missed appointments and those canceled without 24 hours notice.
5. All accounts not paid within 90 days will automatically be put through to on outside collections agency, which may affect your credit.
1. The privilege of insurance assignment begins when our office receives your insurance forms.
2. All deductible payments must be made prior to insurance submittal.
3. You are considered to be a cash patient until our office qualifies your coverage to determine the extent of benefits under your policy.
4. Due to frequent erroneous information when qualifying benefits, in the event that your insurance company does not comply with the coverage that is quoted to us, you are ultimately responsible for payment.
5. All patients whose visitation schedule is once per month (or longer) will not be eligible
for insurance assignment unless otherwise stated. Charges for services rendered will once again be due as they are received.
6. Should you discontinue care for any reason other than discharge by the doctor, any and all balances due will become immediately payable in full, regardless of any claims submitted.
7. This office does not promise that an insurance company will reimburse you for the usual and customary charges submitted by this office, nor will we enter into any dispute with an insurance company over the amount of reimbursement.
8. Since we do not own your policy, and, occasionally, we experience difficulty in collecting from the carrier, we may ask for your active assistance in rectifying this situation.
9. Lastly, it is the goal of this office to provide you with the finest quality chiropractic care available. If you have any questions with regard to your health care, or any of our policies, please let us know. We look forward to your referrals and to a doctor-patient relationship that works for our mutual benefit.