Private Insurance and Medicare: The services provided by our practice may be covered by your insurance, including Medicare. However, we do not guarantee or represent that any of the services provided are reimbursable by any insurance network. If you elect to have us submit a claim for coverage to insurance, we will collect your insurance information prior to or at the time services are rendered. In the event our services are not covered or if you are responsible for any cost-sharing amounts as part of your coverage, we may collect these amounts at the time of your visit or may provide you with an invoice for payment after services are rendered.
Cash Pay: If you elect to receive services on a cash pay, fee for services basis, payment in full is due at time services are rendered. Payment for services must be made through the online payment service on the website.
Should you wish to submit your claim to insurance yourself after electing the cash pay option, we will provide you a receipt for services provided which you may submit to your insurance company for possible reimbursement.
All reimbursements from your insurance received in this manner must be made out directly to you.
Medicaid Patients: We do not provide services to patients enrolled in Medicaid. If you have coverage through Medicaid, you may only receive services from us as a private pay patient. If you elect to receive services as a private pay patient, you will be asked to complete a Client Acknowledgement Statement.
Cancellation: As a courtesy to others and our providers, we require a 24-hour cancellation notice if you cannot attend your appointment. We may place reminder calls on the day prior to your appointment, but it is always your responsibility to remember the time and day of your appointment. If we do not receive the notification to cancel over 24 hours from the appointment, you will be charged in full. If you are more than 15 minutes late to your appointment, you may be required to reschedule the appointment and pay for the missed appointment. By signing below, you agree that we may charge the cancellation fee to the credit card account on file with us.
No Refunds: All payments made for the services provided are irrevocable, non-refundable, and non-creditable, in whole or in part, for any reason whatsoever.
