DIRECT BILLING & INSURANCE

Most direct billing insurers require an additional completed consent form. If you would like the clinic to direct bill on your behalf, we require an additional completed form to process direct billing for policies that require it. This electronic form will be emailed to your account email address within 72 hours following your initial consultation from our Wondershare DocuSign service. Please monitor your spam folder during this period.

 

This direct billing authorization must be received and completed accurately within 48 hours of our office sending it. We will wait 48 hours after sending the Wondershare direct billing authorization to receive the completed form.

 

If you fail to return the form to use within 48 hours of our office issuing it, the credit card on file will be billed for the services delivered, and a receipt will be issued. If you fail to return the form within our 48-hour window, you will need to submit this directly to your insurer for reimbursement. 

 

For administrative reasons and costs associated with credit card fee returns, our office will not direct bill for services that have already been charged when forms are not returned within 48 hours of our office sending them. We appreciate your understanding and are happy to direct bill for future visits as soon as our office receives the completed forms.

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Should your insurance details change, a new authorization will be required with the new policy details listed. Please let us know if your insurance changes so we can issue a new billing consent for your new plan. Failure to provide the authorization forms or correct/updated information within 48 hours of our office sending them through our Wondershare DocuSign service will result in your credit card being charged the full treatment value and a receipt issued. The patient will need to submit the invoice to their insurance for reimbursement. The clinic will not go back and reprocess direct billing for administrative reasons for forms that have not been returned within 48 hours of our issuing them through the Wondershare DocuSign service. Please monitor your spam folder.

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Multiple plans. We cannot always direct bill multiple plans due to insurance policy-related processes outside our control. In such instances, an invoice will be provided so a patient may submit the balance after their primary plan has been direct billed to a secondary insurer for further reimbursement if the clinic cannot complete both on their behalf. We appreciate your understanding and do our best to accommodate these as it helps us minimize credit card transaction fees. We always prefer direct billing when possible.

 

Please scroll below for a list of insurance providers we are set up to direct bill if your plan allows it.