OpenMind Medicine Krista Tricarico, NDOffice Policies • March 17th, 2013
Thank you for trusting me with your health care. I take my commitment to you very seriously, and I look forward to working with you to enhance your health and well-being. The following are my office policies. Please read them carefully and initial next to each policy.
Office PoliciesOffice Policies • May 11th, 2020
As a courtesy to our patients we gladly submit your insurance claim. All deductibles and copays are estimated and are due at the time services are rendered. While we do our best to provide insurance coverage information it is ultimately the patient’s responsibility to know their plan and history information. Parents must send payments due in with minors at the time of their appointment. If your insurance company fails to pay for your treatment within 30 days, you are responsible for the account balance. If you need to make financial arrangements to take care of your balance please call or visit our office. Appointments that are more than 1 ½ hours require a deposit in order to be scheduled.
SPORTS & SPINE CHIROPRACTICOffice Policies • July 28th, 2009
Office PoliciesOffice Policies • October 15th, 2018
As a courtesy to our patients we gladly submit your insurance claim. All deductibles and copays are estimated and are due at the time services are rendered. While we do our best to provide insurance coverage information it is ultimately the patient’s responsibility to know their plan and history information. Parents must send payments due in with minors at the time of their appointment. If your insurance company fails to pay for your treatment within 30 days, you are responsible for the account balance. If you need to make financial arrangements to take care of your balance please call or visit our office. Appointments that are more than 1 ½ hours require a deposit in order to be scheduled.
NOTE: Some of these policies are new, we highly suggest you take the time to read the form in its entirety. Services cannot be provided until this agreement is signed by the patient or patient’s legal guardian. By signing this agreement, you...Office Policies • February 3rd, 2020
Cancellation and No-Show Policy: Exam slots are limited and valuable. To serve our patients better, we ask for proper notice for any cancellation. All patients are required to provide at least 24 hours advance notice when cancelling an appointment so that we may provide other patients with care. We understand that you may miss your appointment due to an emergency, for this reason we also reserve the right to asses each situation on a case by case basis. While we do provide reminders the day before the appointment it is the patients responsibility to remember the appointment.
Client Rights, Office Policies, Financial AgreementOffice Policies • August 20th, 2017
Consent for Treatment: You hereby consent to such treatment procedures and client care which, in the judgement of your provider and/or physician, may be considered necessary or advisable while a patient of Premiere Speech and Hearing.
