Patient Responsibility Statement
Know your insurance coverage. Our business Office’s goal is to be your advocate regarding payment of your bill. Each patient’s medical problems are unique and charges will vary according to the extent and nature of the services provided.
Be familiar with what your insurance company does and does not cover. You are responsible for paying any charges or balances your insurance company does not cover. Payments for co-pays and non-covered services are due at the time of visit unless prior arrangements have been made. You are responsible for paying your bill within 30 days of receiving your billing statement in the mail.
We will file your claims to your insurance carrier. To avoid out-of-pocket expenses we encourage you to check with your insurance company to insure that you have coverage for the visit. To find out more information about your insurance coverage, and to verify Dr. Thie is a provider for your plan, please call the customer service phone number listed on your insurance card or access their website. Your human resource department at your employment may be helpful as well for more information.
No-Show / Cancellation Policy
In order for our office to provide you with the best care possible, we ask that you make every effort to keep your scheduled appointments. Good medical care and a positive doctor-patient relationship are dependent upon consistent consultation and treatment. This cannot be accomplished with frequent missed and/or no-show appointments.
If you miss an appointment or cancel with less than 24 hours notice, Dr. Jennifer L. Thie reserves the right to bill you $50.00 for each no-show or late cancellation. This fee will be your responsibility and will not be billed to your insurance company. This fee must be paid in order to schedule another appointment with our office.
We do realize that on rare occasions emergencies may arise and we will address these situations with you at the time.
In addition to the $50 fee, Dr. Thie also reserves the right to discharge you from the practice after three (3) missed appointments. A letter of discharge will be sent via certified mail. Dr. Thie will continue to provide care for thirty (30) days following receipt of the letter to allow you time to make alternative healthcare arrangements.