Our goal is to build a successful relationship with you. Your understanding of PALM Health, LLC’s and PALM Integrative Medicine, PC’s (together, “PALM”) financial policy and your responsibility for payment of services is important to our professional relationship. If you have any questions about our fees or policies, or your responsibilities, please ask a PALM Navigator. It is your responsibility to notify us of any changes in your name, address, telephone, or insurance information.
VISITS WITH MEDICAL DOCTORS
PALM is not in network with insurance. Therefore, PALM does not collect copays for visits. Depending on your membership level, your program may include your medical visits and services. If the services are not included, you are responsible for paying each service based on our fee schedule.
We will use your insurance information to help you obtain prior authorizations for your insurance to cover diagnostic imaging, tests, medications, and medical care outside of PALM.
Labs submitted through Quest or LabCorp will be processed through your insurance.
Specialty labs are typically not processed through insurance and may not be eligible for Insurance Correspondence Forms (“Superbills”). You are responsible for payments of specialty labs at the time of service. You can reference the lab brochure to determine if it might be eligible for insurance reimbursement. If the lab payment is eligible, PALM will provide you with information to submit to your insurance for possible reimbursement at the time of service.
INSURANCE CORRESPONDENCE FORMS: (I.E. “SUPERBILLS”)
For certain services, we can provide Insurance Correspondence Forms, known as “Superbills.” The forms include the necessary diagnostic and treatment codes so that you may submit to your insurance company for reimbursement. However, we cannot guarantee repayment even with the Superbill. Of note, if your visits are included in your membership program, we cannot provide you with an Insurance Correspondence Form (“Superbill”) for the individual service. For an up-to-date list of services that qualify for Insurance Correspondence Forms (“Superbills”) please visit our website FAQs.
Importantly, PALM cannot provide Insurance Correspondence Forms for services included as part of your membership program fee. PALM will provide you with Superbills at the time of service. We will create or reprint the ICFs for approximately the last 6 months. Please contact email@example.com if you need assistance with ICFs. If you need 5 or more ICFs per month recreated or reprinted, there will be a charge of $10 per ICF. This will be charged directly to your account. If you would like our Account Services team to call your insurance company to determine the reason for denial, or if you would like assistance with other coverage for services, our Account Services team can provide you with that assistance for $50/hour. You will need to sign a form agreeing to this charge, which we will give you beforehand.
Historically, Medicare has not accepted Superbills and does not reimburse patients for Superbills. If your carrier requires additional forms to be completed, a charge will be associated.
HSA (HEALTH SAVINGS ACCOUNT) AND FSA (FLEXIBLE SPENDING ACCOUNT) ACCOUNTS
In some cases, PALM’s fees may be paid for using your employer-based Health Savings Account (HSA) or Flexible Spending Account (FSA). Contact your health insurance representative for specific details on your HSA and FSA benefits coverage.
WORKERS’ COMPENSATION AND AUTOMOBILE ACCIDENTS
Established patients may be eligible for treatment for work-related injuries and automobile accidents; however, the patient is responsible for paying at the time of service for treatment of these injuries. The patient is responsible for working with their employer or insurance carrier for reimbursement.
WELLNESS SERVICES & COMPLEMENTARY THERAPIES
Wellness services and complementary therapies include but are not limited to chiropractic visits, acupuncture, NAET, intravenous (IV) nutrition, coaching, counseling, personal training, facials, and massage. You are responsible to PALM for payment in full for these services at the time of the visit.
Membership dues and fees will be charged pursuant to the terms of the membership agreement.
Payments of past-due balances must be made prior to a scheduled appointment. This includes past-due balances of membership fees.
MISSED APPOINTMENTS AND CANCELLATIONS
If you must cancel an appointment, please give at least 24 hours notice, to allow us to offer the appointment to another guest. Failure to keep appointments without proper notice may be cause for PALM to discontinue providing services to you.
Missed appointments or appointments cancelled inside the 24-hour window are subject to a cancellation fee as below:
Wellness, Spa, or Complementary Therapy Services
100% of the service, or loss of service from a prepaid package.
$100 for cancellations or missed appointments with a medical doctor or nurse practitioner.
Services included in Unlimited Packages and Membership Benefits
Services booked as part of a monthly unlimited package or membership benefit (such as unlimited monthly salt room visits, classes, cryotherapy, fitness center access, BioMat, or Cell Recharge) are subject to a $20 fee if cancelled with less than 2 hours’ notice.
A returned check charge of $25 will be payable by cash or money order along with the fee for insufficient funds rendered by the bank.
MEDICAL RECORD COPIES
Charges for copies of medical records will be in accordance with state recommendations.
If previous arrangements have not been made with our Account Services Manager, any account balance outstanding over 90 days will be forwarded to a collection agency, at PALM’s discretion.