Patients with Insurance
Deductibles and all co-payments are expected at the time of service or at the end of each week. Your co-insurance balance may not exceed $150 or professional care may be terminated. Deductible may be satisfied with MasterCard or VISA.. Finance charges may be applied after thirty days.
A. The privilege of insurance assignment begins when your insurance forms are received by our office.
B. All deductible MUST be made prior to insurance submittal.
C. Our office will qualify your insurance coverage in an effort to help you determine exactly what chiropractic coverage is available to you under your policy.
D. It is our policy that a 60% the total bill be paid as you go, regardless of the percentage of your deductible. All co-payments (deductible) are payable when service is rendered or at the end of each week. (Co-payment is that part of our service that is not paid by your insurance). Refunds will be issued on accounts with credit
E. This office does not file for or accept co-payment from secondary insurance carriers, but will be happy to assist you in collecting from the secondary carrier. There is a $5 dollar clerical fee for each additional insurance filed.
F. Since we do not own your policy, and, since from time to time we experience difficulty in collecting from insurance companies, ... and, since insurance assignment is a privilege, it may be terminated at any time. If your insurance company is difficult then we WILL discontinue allow their contractees to use "pay one third as you go" policy. Of course, we will give you ample notice and ask that you act in your own behalf with your insurance company.
G. All patients whose office visit schedule is once per month or less will not be eligible for insurance assignment. Charges for services rendered will again be due as they are rendered. Of course, we will continue to assist you in collecting from your insurance company by submitting bills on your behalf.
H. This office does not promise that an insurance company will pay for the usual and customary charges of this office, nor will this office enter into any dispute with an insurance company over reimbursement or the amount of reimbursement.
I. Should you discontinue care for any reason other than discharge by the doctor, any and all balances due will become immediately due and payable in full by you, regardless of any claims submitted.
J. When making a health care decision, it is important to remember that you, the patient, are ultimately financially responsible for any services rendered.
K. 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 welcome your referrals and look forward to a doctor-patient relationship that works for our mutual benefit.
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