Financial Policy
We emphasize that, as healthcare providers, our relationship is with your, not your insurance company. We will bill your insurance company providing you give us an accurate, legible copy of your current insurance card (both sides) at your first appointment. We do not take any responsibility for any denial of claims by your insurance company (including but not limited to): denials due to lack of authorization, pre-authorization, limitations on your insurance policy, or because of any delays in receiving your health insurance information. Verification of your insurance benefits does not guarantee payment by your insurance company. You are responsible for understanding any/all limitations on your insurance policy, including visit limits/caps on amount paid, etc.
Guarantee of Payment
I hereby guarantee payment of physical therapy expenses for the above-mentioned patient while at Vail Physical Therapy, LLC. I am the patient/legal guardian/parent, etc., for the above patient and accept legal responsibility for all expenses. I understand that I am financially responsible to Vail Physical Therapy, LLC for any/all expenses incurred, including those not covered by or paid for by my insurance company. I also understand that I am financially responsible if a problem develops with my insurance carrier and payment is not made within 60 days. Should this account become delinquent, I understand that I will be responsible for any and all collection/attorney/filing fees incurred in trying to collect payment.I verify that the above information is current and accurate. I have read and agree to the statement above and I am seeking treatment voluntarily. My signature authorizes payment of any insurance benefits to the supplier of services (I assign any/all benefits directly to Vail Physical Therapy, LLC.).
Cancellation Policy:
Vail Physical Therapy reserves the right to charge $50.00 for appointments canceled within 24 hours of appointment time.