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Financial Responsibility: You are responsible for keeping up with the benefits that your insurance provides. In the event that your insurance denies your claim for any reason, you will be responsible for all services rendered whether your insurance pays, and whether you agree with our recommendations.
Insurance: We file your insurance as a courtesy to you. If we are not a provider with your insurance, or if they refuse your claim, you will be responsible for the total cost of the office visit and any procedures performed at the time of service.
Accounts: Unpaid balances due after ninety days are turned over for collections with a 30% collection charge.
We charge a "no show fee" without 2 full business days’ notice of $50 and may ask you to place a deposit as a condition of granting an appointment. With Medicare patients, we can request payment of the Medicare Allowable Charge as a deposit or at the time of service. Balances are due in 30 days on unpaid accounts in full. You are responsible for any copay at time of service.
Courtesy to Staff: you may be discharged from care for rudeness to staff verbally or in writing.
Surcharges for debit/credit cards: 4% convenience fee is added for use of a card. This is not charged for cash payments or checks.
Payments and Account Fees: Returned Checks $60 fee. Thirty-day late balance fee is a $25 fee every 30 days. Referral to collections is a 30% surcharge.
Controlled Substances: Per TN State Law and our policy, controlled substances (sedatives, stimulants, opiates, cannabinoids, scheduled antimigraine or antiepileptic agents) cannot be refilled without a bona fide patient encounter. The responsibility belongs to the patient for obtaining a timely visit to assure no lapses in therapy. The State of TN has implemented strict rules which may invalidate your refills if you are late by two days on a 30 day schedule. We will not issue new prescriptions without an encounter. For opiate classed medications, you need to complete special consents regularly. For many drugs, you will have to complete a urinary drug screen regularly. This is state law and not optional.
Generic drug policy and preauthorizations: we reserve the right to decline to preauthorize generic medications for which we suspect it to be a futile exercise and valid easily obtainable discounts are available from pharmacies to you.
Long-term therapies: we reserve the right to require you to have a bona fide encounter for the purpose of monitoring a therapy prior to renewing an authorization or prescription.
Remote visits: We often offer remote virtual visits. These are constrained to states where the professional is licensed (Tennessee). We cannot refill controlled substances during a remote visit per the Drug Enforcement Agency. You may be responsible for the cost of the visit if the insurer declines our charges. You must have high speed internet with a video and microphone, or this capability on a mobile phone or tablet. You need to have a suitable blood pressure measurement and weight prior to the appointment, and submit all your medical information.
Duplication of effort and failure to coordinate care: if you seek care from a similar professional without us referring you, or you fail to have this professional contact us in an emergency who renders care, we may discharge you from our care, as you are under the care of another professional. If you see another professional without obtaining a complete copy of your medical record for us to review, you may be discharged from practice.
Financial irresponsibility or Serial "No shows" or Late Cancellations: patients who no show or late cancel three times may be discharged from the practice. Patients who refuse to address their accounts will be turned over for collections and discharged from the practice.
Accepting these policies is a condition of rendering service.
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