Patient Financial/Rescheduling Policy

Please read carefully and sign at the bottom of the page indicating your understanding and acceptance of our policies and procedures.

I am aware that Dr. John’s Best Health LLC, is a Direct Pay practice. I have read the Pricing and Payment policy, and agree to pay in full for services rendered at the completion of my office visit. Payment can be made via Cash, Check, Debit/Credit card. Please note that you will be charged $35.00 for any checks with nonsufficient funds. *For Home Visits, I am aware that fifty percent of the consultation fee is to be paid prior to my consultation, and the balance fifty percent paid after the consultation has been completed. Dr. John’s Best Health LLC will provide the appropriate invoice (itemized bill), so that you may submit the charges for the services provided, to your insurance company for possible reimbursement. *Medicare recipients cannot submit to Medicare for reimbursement, but may submit to supplemental insurances. This practice understands that situations arise in which you must cancel your appointment. It is therefore requested if you must cancel or reschedule your appointment, you provide no less than 24 hours’ notice. This will enable another person who is waiting for an appointment to be scheduled in that appointment slot. There will be a $150.00 fee charged to all clients who miss scheduled appointments and fail to provide 24 hours’ notice to the practice. For Home Visits, the fifty percent deposit is refundable if greater than 24 hours’ notice is given prior to the scheduled appointment. If the Home Visit appointment is cancelled with less than 24 hours’ notice, the deposit is nonrefundable. The cancellation fee will be waived, if cancellation is due to emergencies, and or hazardous weather conditions. Patients who do not show up for appointments two (2) or more times in a twelve (12) month period, may be dismissed from the practice thus being denied any future appointments.

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