Billing and payment options

During the registration process, we will ask you to sign a Payment Card on File Agreement. After our office receives remittance advice/information from your insurance company (typically in two to four weeks after your visit), any remaining balance will be charged to your payment card. We will notify you via email 10 days before we submit the charge to your payment card on file. You may call our office if this presents a problem or hardship for you, or if you would like to pay with a different card. You will receive an emailed receipt after the payment has been processed. If the payment transaction is declined by your card, we will mail a billing statement to you, requesting an alternative form of payment.

Exceptions to Payment Card on File Policy

Our Payment Card on File policy does not apply to the patients listed below:

• Patients experiencing a medical emergency
• Medicare or Medicaid or dual coverage patients (Traditional or Managed Care)
• Veterans' Administration/Tri-Care patients
• Occupational Medicine patients (Workers compensation & Employer-paid services)
• Cash-based services when the visit is paid in full at the time of service (i.e., DOT/school & sports physicals, flu shots, forms review, etc.)
• A patient paying cash in full at the time of service
• Telehealth services patients (unless the virtual visit resulted in an in-clinic visit)
• HCA Healthcare employees and beneficiaries who have HCA Healthcare insurance
• Healthy Savings patients

Copays and deductibles

Copays, deductibles and coinsurance will be collected at each visit (if applicable). All patient claims will be submitted to insurance. If a patient elects not to provide a payment card on file, they will be charged a minimum $100 deposit inclusive of copay, coinsurance and deductible. Any amount collected at time of service that is greater than the final patient responsibility will be refunded after the insurance carrier confirms final patient responsibility.

Our payment policy helps patients better manage visit-related costs and simplifies the patient experience, allowing us to focus on delivering exceptional patient care. The process will reduce the amount of statements mailed to patients.

We abide by national payment card compliance standards and the product is HITRUST CSF Certified. The HITRUST security and privacy framework leverages nationally and internationally accepted security and privacy-related regulations, standards, and frameworks. The payment card merchant services processor providers our system an encrypted token that references your card. Our system only has access to the encrypted token. You authorize that access when you sign our authorization form. We do not keep any payment card information on file in our office or on any of our computers.

You will be charged the amount indicated on your explanation of benefits (EOB), less any payments made at the time of service including copays, to a maximum of $180 per visit. Any additional patient responsibility will be billed separately. In no event will we charge your card more than $180.

We accept all major credit cards, debit cards, and HSA, HRA, and FSA cards.

We will always work with you to determine if there has been a mistake on your bill, and we will refund you if we have made an error. You can contact our billing department at (844) 422-3627 from 7:30am - 6:00pm CST with any questions.

Due to the complexities of the current healthcare billing practices, we have elected (as has much of the healthcare industry) to take this approach to simplify the process for both our patients and staff.

If you do not fall into one of our noted exceptions, we will collect a minimum of $100 through a combination of copays, deductibles, coinsurance and/or deposit at the time of service. After your claim is fully processed, if a refund is due, you will be reimbursed by our billing office.

Why do I have to swipe my card with each visit?

While a payment card can be saved to a patient account until it either expires, it declines or you change your payment card on file, we ask that patients swipe, insert or tap their card for each visit. Swiping, inserting or tapping your card each visit ensures our clinics can timely associate your payment to the proper clinic and patient account.

What if I don't have insurance?

If you do not have insurance, you will be eligible for our self-pay pricing posted on our website. You will be requested to place your card on file noting the exception to paying cash in full at the time of service. You will be required to pay the minimum tiered pricing prior to receiving services.

I have insurance and know my copay. I will pay that and if I owe more after the insurance is processed, then you can bill me. I will NOT participate in credit card on file. Can I be seen?

Yes, but we will collect a minimum deposit of $100. This balance protects us in the event your insurance carrier determines that the patient's responsibility is greater than the amount of the copay after we provide care.