For the protection of our staff, aggressive, violent, insulting or offensive behavior by patients or accompanying persons will result in the patient being discharged from the clinic. Every reasonable attempt will be made to find a competent health professional to assume their care.
Children or those with special mental needs attending the clinic are the responsibility of their parent, guardian or caregiver. The clinic will not take any responsibility for any accident or injury caused to such persons in the event of improper supervision. Damage caused by improper supervision will be charged by the practice.
Children under the age of 16 or those with special mental health needs will not be treated in the absence of a suitable chaperone.
Payment for care is due immediately at the time of service. Payment can be made by cash, check or debit/credit card. Patients undergoing a program of care may pay for a block of treatment sessions in advance should they wish.
Insurance, Work Comp, and Motor Vehicle Accident claims information is needed prior to beginning treatment. This includes claim number, police report, adjuster information, and all insurance billing information along with a copy of the insurance card.
If the required billing information is not available for the first appointment, care may be referred elsewhere or appointment rescheduled. The patient may have the option to pay as a cash patient until insurance information is provided.
Patients with private health insurance are advised to check the details of their policy prior to incurring fees for care. The contract between the health insurance provider and the member does not include the clinic. Our staff checks your insurance benefits and takes that information into consideration when collecting for the appointment. However, the sum we request at checkout is only an estimate of your out-of-pocket responsibility based on our understanding of your insurance benefits. You may owe more than collected, or you may have paid more than required by your plan. You will receive a statement of account showing your balance due, or we will send you a check for an account credit balance.
Auto accidents/workers compensation, Motor Vehicle Accidents (MVAs) will be filed to your auto insurance as a courtesy to you. Failure to receive payment within 30 days of the date of service may result in you becoming responsible to pay the balance.
Our office will send appropriate workers compensation claim forms for services rendered on your behalf as a courtesy. If a claim is denied, we will expect payment in full from you within 30 days of receipt of our statement.
Patients wishing to cancel their appointment should do so at least 5 hours in advance. Patients failing to keep their appointment (not turning up) will incur a fee for the missed appointment.
Collections and Outstanding Balances: We do our best to work with patients on collection of account balances. We ask that a patient pay a minimum of $20 per month to satisfy their account balance. If a patient has an account balance over 120 days old with no payment made by the patient in the last 30 days, the account will be referred to an outside collection agency. Accounts referred to an outside collection agency will be subject to a collection fee of 20%, which will be added to the total balance due.