Prior to your initial visit you need to obtain all the necessary paperwork. We ask you to read and complete this paperwork at home (in non-urgent cases) to give you time to think through your answers and to make the most out of your time in our office. You may also want to visit our website (www.MtTamSportSpine.com) to learn more about the services offered in our office, what to expect on your first visit, and to find answers to some questions frequently asked by patients.
If applicable, please bring copies of your latest laboratory and imaging (x-ray, MRI, CT) reports—no film required—on the day of your initial exam. If your doctor requires an ‘Authorization to Release Medical Records’ form please contact our office and we will provide one for you. Often your laboratory and imaging reports can be faxed or emailed directly to you by your doctor.
Our goal is to provide you with the best personalized health care at an affordable price.
Non-Medicare Health Insurance:
We are “out-of-network” for all* insurance companies. To find out about your out-of-network benefits, call the customer service number on your insurance card and inquire about your chiropractic coverage. We do not bill or directly communicate with insurance companies; however, we are happy to provide you with a “superbill” that includes the information you need to file a claim. Any reimbursement will then be mailed directly to you from your insurance company. There is no out-of-network reimbursement for Medicare, Tricare or Kaiser/HMO patients. If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA) the “superbill” will also validate your expenses in our office as healthcare-related to those entities. Payment for each visit is required at the time of service.
We do accept Medicare as a “non-participating physician.” This means that we collect the full amount of your visit charges at the time of service and then send in your Medicare billing for you. Medicare and your secondary insurance policy (if you have one in place) will then reimburse you, based on the details of your health coverage, by sending a check directly to you. Medicare is particular on what chiropractic services they will cover and we will go over these details with you during your first visit.
Many doctors offer supplies (glasses, crutches, supplements, etc.) at their offices for the convenience of their patients. Depending on the nature of your case, the doctor may recommend nutritional and/or support products such as vitamins/minerals, botanicals, joint braces, etc. Although he/she does suggest commercial products (health food stores, online, etc.), most are recommended from our office for several reasons. Years of clinical experience shows that most commercial products are poor quality, in spite of the label claims. We carefully select ‘professional grade’ products from various
reputable manufacturers. Additionally, California Tax law states that the patient doesn’t have to pay sales tax on these products when sold in a chiropractor’s office. That is nearly a 10% savings for patients. Please note that no patient is required to purchase products from our office, however if you choose to purchase over-the-counter products of lesser quality, you should not be surprised if you obtain sub-optimal results.
Product returns must be made within thirty (30) days of purchase. Unopened products (supplements and/or orthopedic supports/supplies) that are returned within 30 days will be given a full refund. All supplement returns must be unopened and sealed inside the original packaging. Opened supplements may not be returned. No refunds are offered on services rendered.
No Show & Cancellation Policy
We are committed to offering exceptional patient care during every visit. We have invested in equipment, training, and systems to make your visit comfortable and effective. We pride ourselves on consistently running on time. We will be ready for your appointment with our full attention and energy. We ask that you prepare for your appointment accordingly. Please silence your cell phone prior to your visit. Please come dressed appropriately for the area to be treated (ex: don’t wear tight jeans if we are going to be working on your knee). We have a 24-hour cancellation policy on all appointments. No-shows or cancellations with less than a 24-hour notice will be billed the full fee of the appointment. Our staff will make every attempt to remind you of your appointment, but it is ultimately your responsibility to remember. If you are running late please call to let us know when you anticipate arriving for your visit. We will do our best to accommodate your revised visit time into the doctor’s schedule. However, our office makes a policy of not pushing the entire day’s schedule out because a single patient is late to their appointment. We will run on time as a rule and we ask that you show up on time for your appointments.
Payment for the initial consultation and treatments is required at the time of service. For your convenience, we accept cash, checks, Mastercard, and Visa.
Additionally, regarding insurance, please be sure to note:
Your insurance policy is a legal contract between you, your employer, and the insurance company. We, as healthcare providers, are NOT a party to that contract.
The doctors at Mt Tam Sport & Spine are not members of any HMO, PPO, or other provider networks. Therefore, any coverage you may have for services provided in this office will be deemed “out of network coverage” by your insurance company.
Many insurance companies will advise you that your coverage will be a percentage of the office fees (e.g. 80% of treatment charges) after a yearly deductible amount has been fulfilled. What is often not specified by the insurance company are plan fee schedules, annual maximums, and other limitations that will have a direct bearing on the reimbursement they allow. For details on your health insurance “out-of-network” chiropractic benefits please contact your insurance company directly.
Release of Information: I authorize the release of any information concerning my health and health care services to my insurance companies, pre-paid health plan or Medicare. I, the undersigned, agree to all the above Office Guidelines and Policies. I have asked, and had answered to my satisfaction, any questions I have regarding these policies. By my signature, I acknowledge receipt of the provider’s Notice of Privacy Practices (HIPPA) and the provider’s Patient Rights and have been given the opportunity to read them. I understand that this information is available to me upon my request, or available online at www.mttamsportspine.com/privacy at any time.