Financial Policy

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HCR 230

Wellness Medical Practice

Part A

Wellness Medical Practice welcomes you as a patient. The practice strives to provide its patients with excellent healthcare. In order to keep the cost of our medical services comparable with other medical providers in the area, Wellness Medical asks patients to become familiar with the practice's Financial Policy. PAYMENT: Each office visit payment is rendered at that time, unless prior payment has not been arranged with billing staff. Payments are listed as co-insurance and co-pays for their insurance holders. Wellness Practice accepts all monetary payments debit and credit cards. A $25.00 return check fee will be applied to account. An outstanding bill that is over 60 days will be required to make payment arrangements before they can be seen in this office for services. The Wellness Medical Practice realizes that families have unforeseen hardships. The practice will recommend other low cost facilities for non-covered services. MINORS: The parent is responsible for payment and will receive billing statements. The parent will have to sign consent for treatment and procedures required for unaccompanied minors. INSURANCE: The Wellness Medical Practice will submit claims for payment. The patient is responsible all other charges. Wellness Medical Practice will not file secondary claims. PREPAYMENTS: Wellness Medical Practice accepts prepayment for services in the form of personal check, bank debit/credit cards, or cash. A receipt will be given to responsible party the receipt will verify services rendered. MANAGED CARE: HMO plans require a referral in order to be seen by a specialist. You will not receive a referral after services are rendered. WORKERS' COMPENSATION AND AUTOMOBILE ACCIDENTS: Injury or automobile accident, you must obtain all information related to the insurance provider before patients visit. REFUNDS: Patient should submit in writing a refund of any monies he believe is owe and allow up to 30 for a...
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