Holistic Allergy & Immunology terms and conditions

Privacy

Protected health information (PHI) about you is maintained as a written and/or electronic record of your contact with, or visits for health care services at, Holistic Allergy & Immunology. PHI includes (but is not limited to) demographic information (e.g., name, address, phone number) that may identify you, as well as information related to your past, present, or future physical- or mental health conditions and related health care services. Holistic Allergy & Immunology is required to follow specific laws on 1) maintaining the confidentiality of your PHI, 2) using your PHI, and 3) disclosing or sharing your PHI with other health care professionals involved in your care and treatment, or entities related to payment or insurance purposes, as permitted or required by law. You have the right to access and control your PHI.

Payment

Full payment is expected at the time of your appointment, per the terms of the service or program package you have selected. We accept payment through HSA and FSA cards, credit cards, Zelle, Stripe, Venmo, CashApp, PayPal, cash, money order, or cashier’s check. In some cases, we will accept personal checks at the time of an in-person office visit (note that if there is any issue with the check, we will charge $100 service fee, in addition to to any fees incurred by the practice if your check is not honored by your bank).

We do not bill insurance, but can provide upon request detailed insurance claims forms for services rendered that you can submit to your HSA, FSA, or insurance company for credit toward your deductible, maximum out-of-pocket expenses, or reimbursement. Please contact your HSA, FSA, or insurance provider with any questions about submitting your claims paperwork.

If your account is over 30 days past due, you will receive a letter stating that you have 10 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative medical care. During that 30-day period, our physician will only be able to treat you on an emergency basis.

cancellation

If you miss your appointment or reschedule less than 24-hours in advance of the appointment, you will be charged a $100.00 cancellation fee, which will be billed directly to you.