The purpose of these agreements is to allow us to more completely serve you and to get the best results in the shortest amount of time. It is our experience that those who adhere to the following agreements get the best results.
When you arrive, please sign in (print) at the front desk. Our Patient Care Representative will confirm your next appointment, you will handle fees for services (if anything is due), and you will then be given your travel card and will go back to see the doctor.
Please adhere to the adjustment schedule as we have specific times to do adjustments and specific times to see new patients and reports. If you come during non-adjusting hours you will be asked to wait until the new patients and reports are processed as they are scheduled for those times.
In the event you sustain a new injury, please let the Patient Care Representative know when you arrive. We would like to have a questionnaire completed for the doctor to review.
It is important that all patients attend our Your Spine/Your Health Workshop. This workshop explains how the body functions, how chiropractic works and most importantly, how you can expedite the healing process. Family and friends are invited to attend. There is no charge for this workshop.
Your Financial Arrangement
We will expect you to honor the financial arrangement made with our office. If you find you cannot fulfill your financial obligation, notify the doctor so that new arrangements can be mode. Our policy is that patient accounts are paid timely and as agreed to in the financial arrangement. Your insurance carrier is expected to pay their portion in 30 days. Our claims are submitted twice weekly. If you do not receive an explanation of benefits from your insurance carrier within 30 days you are expected to call your carrier on our behalf to get the claim paid. If you should receive a check from your carrier, it should be brought to our office with the attached explanation of benefits.
You are scheduled for a certain number of treatments in a set amount of time to get the best result we both desire. Should you have to change your appointment, we would like for you to reschedule at a different time in the same day. If this is not possible, try to reschedule within one week to make up the missed appointment. Progress evaluations, re-examinations and updated films will be performed periodically to rate your progress and future treatment. The goal in our office is to get everyone we see “Get Back to Life” (normal living skills and work activities) as soon as possible. It is of the utmost importance that you adhere to the scheduled plan of treatment as closely as possible.
Off works/school slips are given from appointment to appointment. Should you miss your next scheduled appointment we will not be able to justify your absence from work/school.
Should you choose to discontinue services we ask that this be done in writing. Should you have a refund do it will be issued within 30 days from receipt of letter requesting termination of services. In the event that money is due from you for services rendered payment of outstanding balance is due at the time of termination of services.
Should you have questions regarding billing issues, these calls are handled Wednesday and Thursday 9-4.
We are here to serve you. Please speak with the doctor about anything that could be upsetting you (i.e. long waits, confusion about treatment, etc.). We want your visits at out office to be pleasant and with the best results possible.
As you can see, all these things can help our office run much more effective. Following the above policies allows the doctor and staff to allocate the necessary time to each patient.
1. The right to confidentiality of medical records.
2. The right to be treated with consideration and respect.
3. The right to be informed in an understandable language about their health condition.
4. The right to participate in decisions affecting their health.
5. The right to be informed of the appropriate or medically necessary treatment options available for their health condition.
6. The right to voice any questions, concerns or complaints about any aspect of their health coverage, care/services provided.
7. The right to be informed about our facility and health coverage as it relates to services provided by our facility.
8. The right to be informed of policies by which the patient is to abide.
9. The right to privacy and confidentiality while receiving care.
10. The rights to not accept care or to terminate service at own discretion.
1. The responsibility to supply accurate and complete medical history information.
2. The responsibility to advise staff if information is not understandable.
3. The responsibility to inform staff if the treatment plan does not meet the individual’s need or cannot be followed.
4. The responsibility to follow the agreed treatment plan.
5. The responsibility to contact provider when unable to keep appointments.
6. The responsibility for knowing the terms/benefit coverage for services provided and for fulfilling financial obligations as agreed.