Office Policies:
PLEASE READ CAREFULLY!
1. Our practice is a general chiropractic health care practice. We do not accept personal injury cases that have the potential of being litigated. Therefore, we…
A. Do not accept Worker’s Compensation cases.
B. Do not accept accident cases (vehicle or otherwise) that were caused by another person, business, or vehicle, or have the potential of being litigated.
C. Do not accept Medicaid. Even if you are paying cash, we cannot serve you. It is unlawful and will put our doctor at risk of large fines or jail time.
D. Can see Medicare; however, you will have to file on your own. It is cash pay only.
2. X-rays are not made to determine when or where to adjust, as this is determined by neuromuscular stress testing. X-rays are needed to determine if any disease process, fracture, malformation, or spinal degeneration is present that would make spinal adjusting contraindicated. If warranted, we will refer to Flores Chiropractic for X-rays.
3. Your acceptance as a patient is based on my findings relative to your symptoms and their relationship to your neuro-musculo-skeletal manifestations. The acceptance of your case does not promise a cure; however, it may indicate in my evaluation that you have definite neuro-musculo-skeletal relationship to your symptoms. By becoming a patient you understand that it is best to complete the doctor’s recommendations to achieve your desired results.
4. Cancellation and Fee policy includes:
It is the policy of our office that you pay completely for services when they are rendered. I hereby agree to such fees, and understand that I am liable for any and all legal fees if collection services become necessary.
If you need to cancel you must contact our clinic by phone at LEAST 24 hours Monday-Thursday, within Office Hours in advance prior to your scheduled appointment date and time to avoid the cancellation fees. Failure to cancel within the required time will result in the cost of half of the appointment fee to the card on file. A no show is considered failure to cancel or show for a scheduled appointment, this will result in the full appointment fee to the card on file. Ex) Calling end of day Thursday for Monday AM appointment is not within 24 hours. Your appointment time is not re-fillable; therefore, non-refundable.
For new patients, half of your appointment fee is required upfront to hold your appointment. This is non-refundable if cancelled less than 24 hours within Office Hours Monday-Thursday. Ex) Calling end of day Thursday for Monday AM appointment is not 24 hours. Your appointment time is not re-fillable; therefore, non-refundable. The rest of the amount is paid at the time of check-out.
For all patients returning, half of your appointment fee is required upfront to hold your appointment. The rest of the amount is paid at the time of check-out. This is non-refundable if cancelled less than 24 hours within Office Hours Monday-Thursday. Ex) Calling end of day Thursday for Monday AM appointment is not 24 hours. Your appointment time is not re-fillable; therefore, non-refundable. The rest of the amount is paid at the time of check-out.
*Office Hours are subject to change, but will be posted and updated on the website.
Family Plan payments are due monthly on the day started the month before. Visits must be with patients on the current family plan after all are established. If additional visits are desired, then regular patient price is required. If a patient within the family membership no shows or cancels less than the 24 hours then that visit counts towards the plan. Ex) Calling end of day Thursday for Monday AM appointment is not 24 hours. Your appointment time is not re-fillable; therefore, non-refundable. Visits do not roll over. If you want to end monthly payments, it can be cancelled at the end of the payment cycle. We will give a 48 hour grace period to cancel within Office Hours Monday- Thursday, unless a family member has been seen. Then the grace period is void.
5. We endeavor to serve our patients to the best of our ability and professional training. We expect you, by becoming a patient, to follow the doctor’s recommended treatment program. This is necessary to gain optimum benefit in your case. If you have any questions concerning any of the policies above, please contact the front desk BEFORE continuing with your forms.
By signing this policy sheet, you are stating you understand and will abide by the policies.