Practice Policies
You will be evaluated trained and licensed provider. We wish to take this opportunity to welcome you and also to state some basic principles we believe essential in establishing a good relationship between us. Please read through this information, asking questions as needed.
1. INITIAL INTERVIEW:
Your first history and physical is considered an evaluation interview and exam. At the time of this appointment, the following decisions will be made with you:
- If IV Therapy is an appropriate treatment option Frequency of IV Therapy infusion sessions
- Goals of therapy (what you hope to gain from this process)
2. APPOINTMENTS:
Each appointment varies in length depending on your chief complaint. Typically, 40 min infusion appointments
3. PAYMENTS:
We would greatly appreciate payment in full for each office prior to the start of your appointment. If you do not have a charge card. We will accept cash and check. Please make checks out to “Clinic IV Drip & Botox”.
4. INSURANCE AND FINANCIAL:
CLINIC IV DRIP & BOTOX does not accept insurance. Upon request, I will be given a receipt that I may submit to my insurance for possible reimbursement. As well, I understand that if I cancel within 24 hours or do not show up for an appointment I will be billed the entire amount of the appointment. I have been given the opportunity to ask questions regarding this statement.
Insurance is an agreement between you and your insurance company as to how treatment will be paid for.
We will assist you in any way possible by providing receipts and documentation. We currently do not directly participate with insurance plans. However, we will assist you in by giving you receipts to submit. Some insurance companies will pay for a portion of outpatient IV Therapy infusion services. You should check with your insurance company representative to find out specific requirements and limitations of this coverage. We will be happy to assist you in the preparation of insurance forms if you feel there is a chance your insurance company will pay for these services. The hourly rate will apply. Payments for services received through Clinic IV Drip & Botox are ultimately your responsibility. If your insurance company requires that outpatient IV Therapy infusion services be preauthorized, it is your responsibility to initiate the preauthorization process, i.e. contacting your primary care physician, insurance company, or a third party “gate keeper”. Failure to obtain required preauthorization for outpatient mental health services will result in you being held 100% responsible for all charges.
5. CONFIDENTIALITY:
All information regarding the specific nature of your treatment is maintained at
Clinic IV Drip & Botox and is considered confidential within the office unless specified by you in writing. However, each provider at this office reserves the right to use specialty consultation with other medical providers at the office as deemed necessary. We follow HIPAA and maintain confidentiality.