Payment Policy

• Dr. Glenn Wilcox and Wise Medicine, including Wise Diagnostic and Wise Botanicals, do not accept insurance for services or products. Payment is required at the time services are rendered or products are purchased. Accepted forms of payment include cash, check, money order, and all major credit cards.
  
  
• Dr. Wilcox charges for all services provided, including procedures and consultations. Consultation fees are based on the time required and are billed separately from any other services or tests. They are not automatically included in the cost of other procedures.
  
  
• Although we do not submit insurance claims on behalf of patients, we will provide you with a detailed receipt containing ICD-10 diagnostic codes and CPT procedure codes if requested. You may use this receipt to submit a claim to your insurance provider. However, it is your responsibility to file the claim. We strongly encourage you to familiarize yourself with your health insurance benefits.

Summary
Patients are solely responsible for the full cost of office visits, procedures, consultations, and products at the time of service or purchase.

Appointments
Dr. Glenn Wilcox sees patients in person at the Wise Medicine clinic in Albuquerque, NM. He also offers remote consultations via phone or video for patients throughout the U.S. and Canada. Communication may also be conducted via text and email when appropriate.

Cancellations
Cancellations made less than 24 hours before the appointment or no-shows, including phone and video, without prior notice will incur a $150.00 fee.

Outstanding Balances

• Outstanding balances must be paid in full before additional appointments may be scheduled.
• Payments are applied first to any unpaid balances.
• A $35.00 fee applies to any returned checks. Afterward, only cash, money order, or major credit cards will be accepted.

Authorization to Release Information
I authorize the release of medical or other necessary information to my insurance carrier(s) or related entities for the purpose of determining benefits or processing claims. This will only occur upon request of the patient. This agreement will be kept on file by Dr. Glenn Wilcox.

Payment Agreement
I have read, understand, and agree to the above payment policies and authorize the release of information as stated.