Thank you for choosing Wellness for Women, PLLC, as your health care provider.  We are committed to building a successful healthy relationship with you.  Understanding payment for services and our Financial Policy is important in this professional relationship.  It is your responsibility to keep us up to date with your information, including address, phone, names,  insurance information, etc.  Please ask at any time if you have questions regarding fees, policies, or your responsibilities. 

 

Co-Pays

The patient is expected to present an insurance card at each visit.  All co-payments and past due balances are due at the time of check-in unless previous arrangements have been made.  We will accept cash, check, or credit cards.

 

Insurance Claims

Insurance is a contract between you and your insurance company.  It is your responsibility to know if our office is participating with your plan.  We will bill your primary insurance company as a courtesy to you.  In order to promptly bill your insurance company we require that you disclose all insurance information including primary and secondary insurance, as well as, any change of insurance information.  Failure to provide complete insurance information may result in your responsibility for the entire bill.  Although we may estimate what your insurance company may pay, it is the insurance company that makes the final determination of your eligibility and benefits.  If your insurance company is not contracted with us, you agree to pay any portion of charges not covered by your insurance, including but not limited to those charges above the usual and customary allowance.  If we are out of network for your insurance company and your insurance pays you directly, you are responsible for payment and agree to forward the payment to us immediately upon receipt.

 

Self-Pay Accounts

Self-pay accounts are patients without insurance coverage, patients covered by insurance plans in which the office does not participate, or patients without an insurance card on file with use.  Liability cases will also be considered self-pay accounts.  We do not accept attorney letters or contingency payments.  It is always the patient’s responsibility to know if our office is participating with your plan.  If there is a discrepancy with our information, then you will considered self-pay unless otherwise proven.  Self-pay patients will be provided a 20% discount.  A $50.00 payment is required at the initial appointment.  Payment plans can be arranged if needed. 

 

Third Party Billing

We do not do any third party billing.  Our relationship is with you and not with the third party liability insurance.  It is your responsibility to seek reimbursement from them.

 

Workers Compensation

We do not participate in worker compensation claims.

 

Cancellation of Appointments

If it is necessary to cancel an appointment, we kindly ask for at least 24 hours of notice.

 

Late cancellation and No Shows

Life can get busy and sometimes we can forget appointments.  If you cancel less than 24 hours or no show for an appointment, the first offense will be forgiven.  If this happens a second time, there will be a $50.00 fee billed to your account.  If you have a late cancellation or no show or any combination a total of 3 times you may be discharged from the practice.  Missing your appointments jeopardizes your care and may prevent others from accessing a needed appointment.

 

Completion of Forms Policy
In order for us to better serve you, we request that you provide 7 business days for completion of any forms.

 

Returned checks

The charge for returned checks is $35 payable by cash or money order.  The will be applied to your account in addition to the insufficient funds amount.  You may be placed on a cash or credit card only basis following a returned check.