OFFICE & FINANCIAL POLICIES
GROUP INSURANCE PATIENTS & CASH-PAYING PATIENTS
Thank you for choosing the Bayside Chiropractic, PC team for your health care provider team. We are committed to your treatment being successful. Please understand that payment of our bill is considered part of your treatment. The following is a statement of our financial office policy which must be signed prior to your (or your child’s) initial treatment. All patients must complete our intake information forms prior to their first appointment.
FULL PAYMENT IS EXPECTED AT TIME OF SERVICE (INCLUDING DEDUCTIBLE / COPAYMENTS) VIA CASH, CHECK, OR CREDIT CARD. OTHER ARRANGEMENTS MAY BE POSSIBLE AND ARE ON A CASE-TO-CASE BASIS ONLY, AND MUST BE ARRANGED IN ADVANCE. We work to estimate your cost through your insurance as closely as possible, but there is no guarantee of what your total liability will be until claims are processed.
AS PART OF OUR OVERHEAD REDUCTION POLICY, WE OFFER ALL OF OUR PATIENTS A TIME OF SERVICE DISCOUNT IF PAID ON THE DATE TREATMENT IS PROVIDED. IT IS YOUR CHOICE AS TO WHETHER OR NOT YOU WISH TO UTILIZE THIS OFFER IN LIEU OF YOUR THIRD-PARTY (INSURANCE) COVERAGE, IF ANY.
REGARDING YOUR ACCOUNT
We may accept assignment of insurance benefits as authorized by your signature below after you meet any applicable deductible. Your account balance is your responsibility, whether or not your insurance company pays. We cannot bill your insurance unless you give us all of your up-to-date insurance information. Your insurance policy is a contract between you and your insurance company. We are not a party to that contract. Please be aware that some, and perhaps all, of the services provided may be non-covered services by your insurance company and / or may not be considered reasonable or necessary under your medical insurance policy. If we do not accept assignment of benefits, are not in network or if you have no chiro coverage, we require you to keep your account up
to date. All fees must be paid in full when services are rendered. It is your responsibility to alert us to any changes in coverage. It will also be your responsibility for any collection fees and attorney fees that may arise in the effort to collect any monies due. Interest on any outstanding balance on an account over 30 days will accrue at 1.5%.
Wellness packages are available. By prepaying 10 sessions, you will receive a 10% discount. By prepaying 20 sessions, you will receive a 15% discount. If you suspend or terminate your care and treatment, any outstanding fees for professional services rendered to you will be immediately due and payable.
USUAL AND CUSTOMARY RATES
Our practice is committed to providing the best treatment for our 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, unless we are contracted with your insurance company.
MEDICARE COVERAGE
Our office does accept assignment from Medicare on an 80 /20 basis. Medicare coverage for Chiropractic is limited to acute spinal adjustments only. Any other services (including but not limited to initial exams, re-evaluation, extra-spinal adjusting, therapeutic exercise, massage, or maintenance care, etc.) will be billed directly to you for payment at time of services rendered unless other arrangements have been made prior to the services. Maintenance visits are not covered.
MISSED APPOINTMENTS
A $50 fee will be assessed for any missed appointment not canceled a minimum of 24 hours in advance. This fee is due on the next appointment date or will be billed to you within 15 days.