1. Payment is expected at the time services are rendered unless prior arrangements have been made. This includes Deductibles and Co-Payments.
2. If a remaining balance is owed after your treatment has been processed through your health insurance, you are fully responsible for that balance. Any account with an outstanding balance must make payment at time of next visit.
3. It is your responsibility to make sure your insurance has approved your visit to ETC Physical Therapy. We are happy to assist you in this process. Please make sure your insurance company has been contacted before you see the Physical Therapist.
4. Insurance filing is done as a courtesy for our patients. We cannot guarantee payment by your insurance company. We will file your claims in a timely manner to the insurance companies you have provided. We expect payment in return in a timely manner. Balance will not be carried over 60 days unless prior arrangements have been made. If your claim has been denied for any reason, it may become your responsibility.
5. If you are receiving medical services that will be covered by means other than health insurance (such as Auto Insurance due to an MVA or attorney reimbursement, etc: If you have Med Pay or PIP we will bill under that insurance first, and when the maximum is reached, we will bill your health insurance. The balance remaining will be your responsibility. If you have no health insurance, you will be expected to pay $100 at your initial evaluation and $50 per visit TOWARDS your balance, until settlement of your case.
6. If you have been involved in a personal injury, the Insurance Commissioners of Kansas & Missouri request that you provide all information on your health insurance, the personal injury insurance covering you, and the third party/other driver. IT IS UNLAWFUL TO WITHHOLD THIS INFORMATION.
7. If you are a Workers Compensation Claimant: In the event that your claim for Worker’s Compensation benefits are denied, all services rendered to you will be charged directly to you and you are then responsible for full payment.
8. Cancellation of appointments require 24-hour advance notice, otherwise, we will charge the patient a late cancellation/no show fee of $35. This fee must be paid BEFORE the patient is able to reschedule another appointment. This fee is not the responsibility of the insurance carrier, nor will they pay for the fee.
9. Failure to show to two consecutive appointments will result in your removal from our schedule. A follow-up call will be placed to the patient. If no attempt is made by the patient to schedule another appointment, the patient will be discharged from physical therapy services until a new prescription is provided by the physician.
10. In the event you fail to make payment when due, your account may be placed with a third party for collections which will result in the patient becoming responsible for attorney fees, collections fees, court costs, and finance charges. This debt will also be reported to all three main credit bureaus.
11. As per insurance guidelines, please sign in and out at each appointment