WELLNESS OFFICE POLICIES

Your insurance coverage is a contract between you and your insurance company. We are not a party to that contract. If you have insurance, we will help you receive maximum benefits. However, please note that most procedures in the Wellness portfolio are considered elective and cosmetic or utilize medications that are “off-label”, therefore making these procedures ineligible for insurance coverage.

• If you believe insurance will cover the cost or a portion of the cost of the procedure(s), we must obtain authorization from the insurance company prior to scheduling the appointment.

• We will only bill your insurance company for services if prior authorization has been determined prior to your scheduled appointment.

• In the event we accept assignment of benefits, the patient is still ultimately responsible for all charges. If your insurance company has not paid your account in full within 45 days, the balance is due in full from the patient and/or guarantor.

• If we accept your insurance and your insurance covers the cost of the procedure(s), you are legally required to pay any charges not covered by your insurance, understanding the provided services are considered elective and/or cosmetic in nature and are not likely covered.

Our practice is committed to providing the best treatment for patients and we charge what is usual and customary for our area. You are responsible for payment regardless of any insurance company’s arbitrary determination of usual and customary rates. We file claims as a courtesy to our patients. We will not become involved in disputes between you and your insurance company regarding deductibles, co-payments, covered charges, secondary insurance, etc., other than to provide factual information as necessary. You are responsible for the timely payment of your account.

Payment is due at the time service is rendered unless other arrangements have been made in advance. This includes co-payments, co-insurances, deductibles, and non-covered services per your contractual obligations with your insurance company if your insurance company covers the services. We are legally prohibited from writing off patient responsibility amounts.

Charges are made through our Electronic Medical Records and Revenue Practice Management Service, AdvancedMD. Payment in full will be collected immediately following your appointment. Billing statements, if applicable, will be mailed out by our billing service and are due upon receipt. If you are unable to pay your bill in full when you receive it, please call our office to set up a payment plan.

In the event of untimely payments (if applicable), late fees will be assessed, and an outside collection agency may be utilized to secure payment. There will be a $5.00 late fee charged to any account that is 31-60 days past due. There will be a $10.00 late fee charged to any account that is 60-90 days past due. After 90 days, late accounts will be released to our collection agency. No appointments will be made until the balance is paid in full, unless a payment plan has been approved and set up by management.

Please cancel or reschedule scheduled appointments at least 24-hours prior to the appointment. Failure to cancel or reschedule an appointment at least 24-hours prior to the scheduled appointment will incur a missed appointment fee as follows:

• Notification 24 – 12 hours prior to appointment $50

• Notification 12 hours prior until time of appointment + 15 minutes $75

• Arrival >15 minutes after appointment time (appointment may need to be rescheduled) $75

• No contact, no show $100

We aim to be transparent with our pricing. You will find a list of many of our services and fees on our website (this list is not comprehensive). Our providers’ charges will likely not be covered by your insurance. Our providers will do their best to explain their plan of treatment before services are rendered. It’s best that you contact your health insurance carrier for questions on covered services before scheduling appointments.

We will only bill your insurance company for services if prior authorization has been determined prior to your scheduled appointment.