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 for services is important to our professional relationship. If you have any questions about our fees, our policies, or your responsibilities, please ask. It is your responsibility to notify us of any changes in your address, name, telephone, or insurance information.
VISITS WITH MEDICAL DOCTORS
You are self pay if you have no medical insurance. In this case, PALM has a self pay fee schedule for medical visits. Patients without insurance are expected to pay for services at the time of the visit. Special needs are understood by PALM. It may be necessary to set up a payment plan for a patient requiring extensive treatment. If this situation is necessary for you, please ask to speak with our Account Services Manager to discuss a mutually agreeable payment plan.
The physician’s service is provided directly to you and not to an insurance company. Insurance is a contract between you and your insurance company. Not all services provided by PALM are covered by every plan.
You are responsible for understanding your benefit plan and for knowing its requirements for referrals to specialists, preauthorization of procedures, etc. It is your responsibility to pay for non-covered services. After insurance claims are processed, remaining balances are payable in full within the regularly scheduled billing cycle (usually 30 days).
In-Network Insurance Carriers and Assignment of Benefits
If we are an in-network provider for your primary insurance company, we will bill your primary insurance company as a courtesy to you, with the requirement that you assign benefits, allowing the insurance company to pay the physician directly. To properly bill your insurance company, we require that you provide all insurance information including primary and secondary insurance, as well as, any change of insurance information.
- You are expected to present an insurance card at each visit. Copayments and past due balances are due at time of check-in unless previous arrangements have been made with the Account Services Manager. You may pay by cash, check, money orders, or credit cards.
- Coinsurance, deductibles, and payments for non-covered services, and any other portion of these services not paid by the insurance company, and not normally adjusted as part of our contractual agreement with the insurance company will be your responsibility. Payments for known deductibles and coinsurance are due at the time services are rendered. It is the insurance company that makes the final determination of your eligibility and benefits.
Out-of-Network Insurance Carriers
It is your responsibility to know your out-of-network benefits. If we are out-of-network with your insurance company, you are responsible for your copayment at the time of service. As a courtesy to you we will submit your claim for the balance of your service to your insurance. We will notify you ahead of the service if you will be responsible for any balance not covered by your insurance.
Most of our medical doctors are in-network with Medicare. If a physician is an opt-out provider with Medicare, you will be responsible for the payment in full at the time of service according to PALM’s self pay schedule.
Tricare (State of Missouri Only)
Tricare places non-negotiable billing limits on what PALM is allowed to charge patients with Tricare insurance. PALM is required to comply with these mandated limits even if patients wish to pay out-of-pocket and not submit claims to Tricare. If you have Tricare, or at any point in the future access to Tricare becomes available to you, it is your responsibility to notify PALM. Such access may preclude you from being a patient of PALM.
Workers’ Compensation and Automobile Accidents
Established patients may be eligible for treatment for work-related injuries and automobile accidents although PALM may in its sole discretion decline treatment. The patient is responsible for providing timely billing information for treatment of these injuries.
- Work-related injuries require the patient to provide the employer’s name and phone number so the practice can contact them for approval of treatment prior to the visit.
- For automobile-related injury, the patient is responsible for the charges.
SPECIALTY DIAGNOSTIC LABS
Your physician may recommend specialty diagnostic labs that insurance does not cover. If you are having specialty diagnostic labs PALM will notify you in advance that you are responsible to assume full responsibility for the service. PALM will provide you with a form to submit to your insurance for possible reimbursement.
WELLNESS SERVICES & COMPLEMENTARY THERAPIES
PALM does not accept insurance for wellness services and complementary therapies including but not limited to chiropractic visits, acupuncture, NAET, intravenous (IV) nutrition, hyperbaric oxygen, personal training, and massage. You are responsible to PALM for payment in full for these services at the time of the visit. For services including chiropractic visits, acupuncture, and IV nutrition, PALM will provide you with a form to submit to your insurance for possible reimbursement. Please ask to speak with our Account Services Manager if you have any questions.
Membership dues and fees will be charged pursuant to the terms of the membership agreement. They are not covered by insurance.
PAST DUE BALANCES
Payments of past due balances must be made prior to a scheduled appointment.
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 within 24 hours 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
$20 for services booked as part of a monthly unlimited package or membership benefit (such as unlimited monthly salt room visits, classes, and cryotherapy).
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. A returned check may be cause for providing services on a cash-only basis.
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.