Purpose of Financial Policy
This policy has been put in place to ensure that financial payments due are recovered so that we may continue to provide quality service for our patients. It is important that we work together to assure that payment for services is as simple and straightforward as possible. Our staff will be glad to discuss these policies with you.
Reflex Testing
The testing you are ordering may require reflex testing. Reflex test(s) may need to be ordered when a particular test result indicates that additional testing should be performed. In an effort to keep your costs to a minimum, any additional fees are passed on to you at our cost; there is no upcharge. In the unlikely event that this occurs, by signing below, you understand and agree that you may be responsible for the cost of additional testing.
Insurance & Reimbursement
The testing and services provided by Biometrica are part of wellness and optimization programs and may include clinical review, diagnosis, or limited treatment by licensed medical professionals. These services are offered under a self-pay model and are not submitted by Biometrica to insurance, Medicare, Medicaid, or any third-party payer.
Biometrica does not routinely provide National Provider Identifiers (NPIs), diagnosis codes (ICD-10), or procedure codes (CPT) for insurance billing purposes. However, upon request, we can provide a detailed invoice reflecting the services rendered. This invoice may assist you in submitting a claim for potential reimbursement directly to your insurance provider.
Payment Expectations
Full payment is required prior to the initiation of any testing or service.
Medicare/Medicaid Statement
Biometrica and its affiliates are not Medicare participating providers and do not contract with any payer. Even if the labs to which your specimens are sent are enrolled in Medicare, no claims will be submitted to Medicare, Medicaid, or any other payer for the services provided. These tests and services are not eligible for reimbursement by any government-related insurer or payer.
You will be financially responsible for full payment for any and all testing and other services provided by Biometrica and its affiliates and contractors. You have the right to receive these services elsewhere from a Medicare participating provider or a provider in-network with your health coverage plan or insurance and potentially receive covered services at little or no cost to you. Instead, you are choosing to receive and be fully financially responsible for the costs of services performed by Biometrica and its affiliated labs and contractors.
Payment must be made in cash, cashier’s check, or via credit or debit card.
Collections & Legal Fees
I understand if my account is not paid in full within 90 days, I may be turned over to a collection agency for further processing and incur an additional 35% fee. If legal action is required to recover the balance, an additional fee of up to 50% may be applied to cover legal and administrative costs.
Acknowledgment of Terms
BY REGISTERING, I HEREBY CERTIFY THAT I HAVE READ THE ABOVE ACKNOWLEDGMENT, HAVE HAD AN OPPORTUNITY TO ASK QUESTIONS ABOUT ITS CONTENTS, AND I CONSENT TO ABIDE BY ITS TERMS.