Inclement Weather:

• In the case of inclement weather and we close the office to protect the safety of our staff and patients, you will receive a notification from our office to reschedule your appointment. We will also post updates for these closures on our LifeArts Integrated Health Center, PC and LifeArts Medical, LLC Facebook page.

Personal Data Changes:

• It is your responsibility to notify our office of any address change, name change, insurance company/policy changes, and/or phone number changes in a timely manner.
  
• If we receive a denial of coverage from the insurance company that we have on file, you will be responsible for the billed charges.
  
• If we are unable to contact you or locate you via phone or mail, your account will be turned over to our lawyer for collections.

Children/Minors (< 19 years of age):

• The parent or legal guardian will be the responsible party for billing purposes. In the case of divorce or transfer of custody, the adult who brings the child for the appointment is responsible for payment regardless of what may be stated in the divorce decree.
  
• We will not get involved in matters delaying payment on the account due to legal separations, divorces, or third-party litigations.
  
• If minors are going to be seen in the office without the parent or legal guardian, a current and up to date credit card must be on file with our office to pay the copay/co-insurance at the time of visit.

New Patients:

• We require a $100.00 deposit via cash, check or credit card PRIOR to scheduling your appointment. If you do not show up for your appointment or are more than 7 minutes late for your appointment, you forfeit your $100.00 deposit.
• We will do our best to reschedule you, but please understand that we reserve 45-60 minutes for new patient appointments so we may not be able to reschedule you in a timely manner.

Appointments:

• We strive to provide quality care to our patients. To ensure quality care, we schedule appointments according to patient need, therefore some appointments are scheduled for shorter or longer amounts of time. (See additional page for more specific information regarding scheduled time for appointments). If at any time you feel that you need additional time, please let us know ahead of time so that we can do our best to accommodate you without disrupting other patients.
• Appointments do not only include visits in the office. If you choose to have a phone call or telehealth visit for anything including illness or results review, that service is also an appointment and will be billed appropriately. It is your responsibility to know if your insurance will cover these visits. If your insurance excludes telephone or telehealth visits, you are responsible for the cost of the visit.
• Unforeseen situations can and do occur in primary care. If there is such a situation, you will be notified that our schedule will be behind, and you will be given the opportunity to either wait or reschedule. We appreciate your understanding when these situations happen.
• Additionally, if you are more than 7 minutes late for your scheduled appointment, you may be asked to reschedule. We do our best to accommodate as many patients as we can during the day, so our schedule generally flows quickly between patients. We understand that there are many circumstances beyond your control, but we also do not want to compromise the quality of care that we provide to our patients.

Appointment Cancellations:

• If you need to cancel or reschedule your appointment, we kindly request 24 hours-notice so that we can open that time to other patients. Appointments are in high demand, so early cancellation allows us to give another person the ability to have access to timely care. If you do not provide 24-hour notice, a $75.00 charge will be added to your account. Repeated missed appointments may lead to dismissal from our practice.

No-Show / Missed Appointment:

• We understand that there are emergencies or other obligations at times, however, when you fail to keep your appointment or you cancel too close to your appointment time, we are not usually able to fill this time with another patient who is needing care. To treat all patients equally and fairly, we have a universal policy regarding missed appointments and late cancellations. It is as follows:
• Upon the first occurrence of a missed appointment or late cancellation, you will be charged a fee of $75.00. This fee is not covered under insurance; therefore, it is your responsibility.
• Upon the second occurrence, we reserve the right to charge a missed appointment or late cancellation fee of $75 and
  • Require a non-refundable $75.00 deposit to reserve your next appointment. At that time, the deposit will be applied to your treatment if you keep that appointment OR
  • Allow appointments to be made “same day” where you call on a day that you are available to see if there are openings in the schedule. There are no guarantees that we will be able to accommodate you, but we will try our best.
• If you have more than two missed appointments or cancellations with less than a 24-hour notice in a 12 month period, we may consider dismissing you as a patient from our practice. If you are dismissed, we will only provide urgent care for 30 days while you establish care with another provider.

Insurance:

• As a courtesy to you, we submit your claims to insurance for reimbursement.
• We submit claims for covered services to the insurance company. However, we cannot guarantee payment as insurance companies will only “quote” benefits and they never “guarantee” benefits or payments. Please understand that you, and not your insurance company, are ultimately responsible for ensuring that complete payment has been made.
• We are contracted with many insurance companies to help you receive your maximum allowable benefits. To do so, you must provide us with your personal information including copies of your current health insurance card, social security number, and your photo ID. It is your responsibility to make sure that we have your current information prior to receiving care.
• If you are unable to provide complete personal and insurance information, you are responsible for full payment at the time of service. If payment is then received from your insurance, your account will be credited for future services.
• Since the inception of Obamacare, there are many more “carve out” insurance plans through the major insurance companies. While we may be in network with the company, it is possible that we are not in network with your individual plan. It is your responsibility to know who is in your network.
• Your insurance is a contract between you and the insurance company. We do not have access to, or information about, that contract. We are a healthcare clinic, and our relationship is with you, not your insurance company.
• It is your responsibility to know and understand the amount of coverage you have.

Definitions:

• COPAYMENTS: This is a fixed dollar amount set by your insurance contract that is to be paid at the time of service.
• COINSURANCE: This is a percentage of the reimbursement amount that is set by your insurance that is not covered by them, thus it is your obligation to pay these charges.
• DEDUCTIBLE: This is the annual dollar amount established by your insurance plan that is deducted from insurance benefits. This amount is your obligation to pay and must be paid prior to healthcare services.

Regarding Insurance Plans:

• When we are a participating provider, all copays are due PRIOR to treatment.
• If you cannot pay at the time of service, there will be an additional $10 service charge applied to your account, that you are responsible for.

Office Procedures and Labs:

• Not all services provided by our office are covered by every insurance plan.
• Any service determined to not be covered by your plan will be your responsibility. 

Payments:

• Co-pays, co-insurance, deductible payments, and self-pay payments are due at the time of service.
  
• After we submit your claim to insurance and they pay their portion, any outstanding charges will be billed to your account.
  
• We will alert you of this balance via your Healow App and patient portal, and you can make your payment electronically at that time.
  
• We will mail statements for outstanding balances monthly only to those patients who have requested a printed/mailed statement.
  
• As per the financial agreement, delinquent accounts may incur a late fee for outstanding balances over 30 days. Delinquent accounts with a balance older than 90 days will be sent to collections services.

Collection Fees:

• Accounts that are outstanding and delinquent by 90 days will be sent to collections. If this occurs, you will receive a 25% fee added to the account for attorney fees. You will be responsible for this fee in full. Once accounts are turned over to collections, you will be required to work with them for payment on your account. You will not be able to receive services at our office until your account balance has been completely taken care of. 

Minimum Monthly Payments:

• If your account has accrued a large balance, we will offer payment plans with the following stipulations:
  • Automatic monthly deduction from debit or credit card.
  • If the card declines, we will contact you once to get updated information.
  • If the card declines a second time, we reserve the right to send your account to our lawyer for collections.
  • Automatic payments will be established with the following amounts:

                               Account Balance:                    Minimum Monthly Payment
                               < $100.00                                  $33.00
                               $101.00-250.00                         $50.00
​                               $251.00-500.00                        $100.00
                               $501.00-750.00                        $200.00
                               $751.00-1000.00                      $250.00

• At no time should an outstanding account balance be > $1000.00.

​Accepted forms of payment:

• We accept cash, check, Visa, MasterCard, Discover, American Express, debit cards, and money orders. Returned checks will be charged $35.00 processing fee and we will not accept checks moving forward

​Workers’ Compensation / Personal Injury / Auto Accidents:

• You are responsible for 100% of the costs that are not covered by insurance. We will bill the insurance companies; however, if they do not pay your claim, you are responsible for the claim amount in full once the claim is closed. 
• ​All workers compensation visits, car accident visits, or any other personal injury visit must be authorized BEFORE your visit. If you do not have authorization and claim information, your appointment will be canceled. You must provide us with the responsible party’s information, including their name, address, phone number, claim number, and date of injury. If you do not have this information at the time of service, you are responsible for payment within 30 days.

Medical Records:

• We require that all medical records requests be made in writing. We believe that you should have access to your record, but to ensure that we follow HIPAA guidelines, we can not provide records without the written consent of the patient or parent/legal guardian if the patient is a minor.
• If you request your records printed out, you will be charged a $20.00 fee plus $0.25 per page to be paid before you receive your records. If you request that they also be mailed to you, you will be also charged the shipping fee.
• Alternatively, you can provide us with a USB drive, and we will provide your records in electronic form free of charge. While we will put every effort into providing your records in a timely manner, please provide us with at least a 2 week notice before you need your records. Nebraska law allows 30 days for a healthcare provider to produce medical records.

Products:

• Payment for all products received in the office is due at the time of purchase. There are NO RETURNS on products.

Forms 

• There will be a charge of $35.00 for any form needing to be completed at our office. It can take up to 10 business days for the form to be completed and returned. If the form is completed, brought to the appointment, and only requires a signature, the fee may be waived. This policy will also apply to FMLA, short and long-term disability, and referrals for insurance. This fee is your responsibility and will not be billed to your insurance.

Prescription Refills:

• We encourage you to have your pharmacy send us requests for medication refills. To avoid any interruption in your treatment, please plan ahead if you are going to need a medication refill. We cannot guarantee that refill requests will be completed on the same day of the request. Refill requests will likely not be completed after 4pm Thursday until the following Monday.
• If you have any changes in your medication, use or dose, we will not send in a refill without seeing you in the office. If you are receiving medication from another provider and request that we refill it, we will not do so without an office visit.
• Please note we do not fill narcotic medications or order antibiotics without an appointment. If you need narcotic pain medication, you are required to complete the pain management questionnaires, bring your current medication with you to the office, and be seen in the office for refills.
• In some instances, you may be required to have updated lab work completed prior to a prescription refill. It is your responsibility to keep your follow up appointments and requested lab draws to avoid interruption in treatment.

Laboratory Information:

• It is your responsibility to know what limitations and authorizations your insurance may require for laboratory testing. We have an in-house lab for many tests; those we do not perform on site are sent to Physician’s Laboratory for testing. Some insurance companies have “preferred” lab companies and will not cover the charges elsewhere. Additionally, many insurance companies will not pay for testing that they deem as “not medically necessary” even if we feel that they are. Each insurance company has their own rules and guidelines for what they consider “medically necessary.” If your insurance denies a lab charge, you are responsible for the cost of the test.

Questions for the Provider:

• We are always happy to answer any questions that you may have during office hours. If you call our office and ask to speak to the provider, you will need to leave a detailed message and your call will be returned when time permits.
• During our office hours, we focus on patient care. Messages will be returned when the provider has time. Please note that there may be times when phone calls are not returned until the end of the week or the following week. If you are calling to ask questions about test results, new medications, etc., you will be asked to make an appointment.
• If your question or the reason for your call is urgent, please be sure to let us know that at the time of the call. Urgent calls will be returned as quickly as possible.
• These calls should not be used in place of an office visit or appointment.

Text Messaging,  Facebook Messaging, and E-mail:

• Our personal cell phones do not have HIPAA compliant safeguards for messaging protected health information. Facebook Messenger also is not HIPAA compliant, nor are standard email programs. While we understand that these methods of communication are convenient, they also pose a risk to our clinic regarding HIPAA compliance.
• If you request an email copy of any protected health information, you will receive the information either via patient portal or through an app called DocsInk. DocsInk will send you a link to open so that HIPAA compliance is followed.
• Appointment reminder texts are completed through our software so that it does have the proper safeguards. The Healow App and Patient Portal are also HIPAA compliant. We kindly request that you use these resources for communication if you do not want to call the office.
• As of March 01, 2023, Dr. Julie Howard, DC, FNP-BC will not respond to communications initiated via Facebook Messenger or Text Messaging.

After Hours Care:

• We are a private, primary care office. After office hours and on the weekends, we request that you seek care at an urgent care or emergency room depending on the severity of your concern. If your concern is not urgent, you may leave a message or text our office line and we will return your call on the next business day.

Billing Statements:

• We do not mail statements for outstanding balances unless we have specifically been asked to mail them. Your online patient portal has your account information with the ability to pay your account through your portal. The mobile app (Healow) shows a summary of your account with the ability to pay your account through the app.