Your privacy is important to us. This policy outlines how we collect, use, and protect your personal health information at our clinic.
Information We Collect:
We collect personal, medical, and contact information necessary to provide healthcare services, process payments, and maintain accurate medical records.
Use of Information:
Your information is used strictly for healthcare delivery, billing, scheduling, and communication related to your care. We do not sell or share personal data for marketing purposes.
Disclosure of Information:
We may share information only as required by law, with your insurance company for billing, or with other healthcare professionals directly involved in your treatment. All disclosures comply with HIPAA regulations.
Data Security:
We maintain administrative, physical, and electronic safeguards to protect your information from unauthorized access, alteration, or disclosure.
Your Rights:
You have the right to access, review, and request corrections to your medical records. You may also request a copy of this policy or revoke prior authorizations in writing at any time.
Financial Policy
Our goal is to provide quality medical care and clear communication regarding financial responsibilities. This policy explains payment expectations, insurance handling, and billing procedures for all patients.
Payment for services is due at the time they are rendered unless prior arrangements have been made. Patients are responsible for all charges incurred, including co-pays, co-insurance, deductibles, and any non-covered services as determined by their insurance plan.
We accept cash, debit, credit cards, and approved health savings or flexible spending accounts (HSA/FSA). Personal checks may be accepted at the clinic’s discretion. Returned checks will incur a $35 service charge.
As a courtesy, we will submit claims to your insurance carrier if we are contracted with them.
If your insurance denies a claim or deems a service non-covered, the balance becomes your responsibility.
Patients without insurance, or those choosing not to use insurance, are required to pay at the time of service. A discounted self-pay rate applies only to services paid in full on the same day.
Co-payments are due at the time of service as required by your insurance plan.
Unmet deductibles or co-insurance portions will be billed to the patient once processed by insurance.
Some procedures, tests, or treatments may not be covered by insurance. Examples include certain labs, wellness services, or aesthetic treatments. Patients must pay for these services in full at the time of visit unless otherwise arranged.
Balances not paid within 30 days of billing are considered past due.
Appointments must be canceled or rescheduled at least 24 hours in advance.
A $50 fee may apply for missed appointments or late cancellations. Repeated no-shows may result in dismissal from the practice.
Completion of forms such as employment, school, FMLA, or disability documents may incur administrative fees. Payment is due when the form is submitted for completion.
Lab work or diagnostic testing performed by outside facilities (Quest, LabCorp, imaging centers, etc.) will be billed separately by those providers. Patients are responsible for any balance not covered by their insurance.
Refunds for overpayments will be issued after verification with your insurance provider and applied first to any outstanding balances. Refunds are processed within 30–45 days once confirmed.
If you have questions about your account or need to make payment arrangements, contact our offices.
Acknowledgment:
By receiving services at this clinic, you acknowledge that you have read, understood, and agree to abide by this Financial Policy.
This clinic provides high-quality medical care through licensed and certified Nurse Practitioners (NPs). By receiving care at this facility, you acknowledge that you are aware your medical services are provided by a Nurse Practitioner.
By receiving care at this clinic, you acknowledge that your healthcare services are rendered by a Nurse Practitioner practicing within their legal and professional scope.
To provide patients with safe, effective, and convenient access to healthcare services through secure telecommunication technology while maintaining the same standard of care as in-person visits.
Telehealth services are available to established and new patients when appropriate for the patient’s condition, the provider’s clinical judgment, and the limitations of remote evaluation. Certain conditions may still require in-person assessment or follow-up.
Patients must provide verbal or written consent prior to participating in a telehealth visit. Consent includes acknowledgment that:
All telehealth sessions are conducted through encrypted, HIPAA-compliant video and communication platforms. Patients are responsible for ensuring privacy on their end by selecting a secure and private location for visits. The clinic does not record telehealth sessions.
Telehealth visits are held to the same clinical standards as in-office visits. Providers may order diagnostic tests, prescribe medications, or recommend follow-up care as clinically indicated. If the provider determines that telehealth is not suitable for the presenting concern, the patient will be advised to schedule an in-person appointment.
At the start of each telehealth encounter, the provider will verify the patient’s identity, location, and emergency contact. Patients must be physically located in a state where the provider is licensed to practice during the telehealth visit.
All telehealth encounters are documented in the patient’s medical record, including patient consent, assessment, diagnosis, treatment plan, and any referrals or prescriptions provided.
Telehealth visits are billed at standard clinic rates. Coverage may vary by insurance plan. Patients are responsible for verifying telehealth coverage and for any co-pays, deductibles, or self-pay charges not covered by insurance.
If technical difficulties interrupt a session, the provider will attempt to reconnect. If reconnection fails, the visit may continue by phone or be rescheduled.
Telehealth is not intended for medical emergencies. Patients experiencing life-threatening symptoms are instructed to call 911 or go to the nearest emergency department.
By receiving telehealth services from this clinic, you acknowledge that you understand and agree to the terms outlined in this Telehealth Policy.