Clinic Policies

SRM Patients’ Policy, Procedure, & Financial Responsibility (PPP$)

PAYMENT POLICY

Payment | Full payment is due at the time of service. We accept all major credit cards, as well as HSA/FSA accounts. A 3% processing fee will be applied to each credit card transaction. Please note that while we accept HSA/FSA payments, coverage cannot be guaranteed for all services or products. Synergy also accepts cash and checks. A $50 fee will be applied for any returned checks.

Outstanding Balances | Any open balances not yet paid will be given a 5-day grace period. Any balance remaining after 5 days will incur a $5.00 daily charge, added to the invoice, for each day the balance is outstanding. After 90 days, the outstanding balance may be subjected to collections and patient dismissed from the office.

Phone Consultations | Established patients may* have the option for follow-up visits via telephone. These are billed $199 for 30-minutes. Calls of 31 minutes will be charged $15 per 10 minutes over, rounded up to the nearest tens. *FDA governing rules will apply for refills on controlled substances; an in-person appt may be REQUIRED to obtain a refill on your prescription.

Regenerative Therapies | All Regenerative Therapy procedures require a non-refundable $250 - $500 deposit (depending on the treatment) with payment is due at the time of scheduling.

Supplement & Specialty Prescription Sales | All special ordered prescriptions must be prepaid. All sales are final; no refund will be given.

Medical Record Request | Medical records, whether from another provider or for personal use, may be obtained by completing a Medical Record Release form prior to receiving the information. This includes the release of laboratory results that have not yet been reviewed by a physician. Please note that Synergy will not print, mail, or send records through snail mail.. Only digital records will be provided. Records can be faxed to another clinic after the requester provides the necessary information or uploaded to their personal portal. Please allow up to 30 business days for the completion of your request.

INSURANCE POLICY

Insurance Statement | Synergy Restorative Medicine approaches patient care in a fundamentally different way than that of conventional medicine. Investigating and identifying the root cause of a patient’s health concerns are paramount in developing treatment protocols and processes that benefit the individual. Often, our physicians are dedicating time before your appointment to studying labs, preparing treatment plans, and personalizing educational programs aimed to equip the patient with the knowledge to regain control of their own health. This approach results in longer appointments and in-depth research and testing as Physicians gather the necessary information needed to identify root cause and develop corrective measures.

Insurance Limitations | Most insurance plans impose limitations on a physician’s ability to provide comprehensive care to patients. Due to the need to adhere to specific fee schedules, appointment times are often restricted to 5 to 15 minutes, and limitations are placed on the types of procedures and testing that can be performed. Conventional medicine often focuses on pharmaceutical treatments that mask symptoms or surgical options that may not be in the patient’s best interest. At Synergy Restorative Medicine, we believe in offering individualized care that addresses the root causes of health concerns. This level of care would not be possible within the constraints of insurance-based models; therefore, Synergy Restorative Medicine operates as a cash-pay enterprise. Additionally, Synergy Restorative Medicine does not provide services for "prior authorizations" related to prescriptions, labs, imaging, or any office services.

Laboratory Services | Typically, lab services are covered by most insurance plans when specimens are sent to "in-network" laboratories. Patients are encouraged to contact their insurance provider to identify in-network labs that will cover the cost of lab work and to provide this information to Synergy’s staff. If no in-network lab is specified, we will utilize LabCorp for laboratory services. Specialty labs are not covered by insurance, and the cost will be discussed prior to the draw.

Note: Medicare, Medicaid, Military, and other government insurance plans do not cover labs ordered by a Naturopathic Physician. Therefore, the cost for these panels/labs will be the patient’s responsibility and must be paid at the time of service. Synergy Restorative Medicine partners with laboratories that offer low out-of-pocket costs to make services as affordable as possible. Additionally, Synergy does not provide services for "prior authorizations" for any prescriptions, labs, imaging, or office services.

Reimbursement | Depending on the insurance company and specific plan(s), a percentage of the services rendered at Synergy may be reimbursed directly to the patient when they submit a “superbill” to the insurance company. Please note that reimbursement highly depends on the in-network/out-of-network coverage and deductible therefore Synergy Restorative Medicine cannot offer any guarantees of possible reimbursement but will supply documentation, upon request, to support the patient’s claim (invoices, superbill). It is recommended that the patient contacts their insurance provider for information on the reimbursement process (if applicable). If a letter of medical necessity is required from your insurance to cover a claim, a $35 fee will be charged per letter.

Taxes | Patients who require receipts or superbills for tax, accounting, or insurance purposes are responsible for obtaining these documents on the day of service. Receipts and superbills are available via email, text, or the patient portal. Please inform the staff at the end of your visit if you require a superbill, so that the document can be created and shared through your patient portal. If an “end of the year” statement is requested for tax, accounting, or insurance purposes, a $35 fee will be charged for processing the information. This fee is waived for current Synergy members.

PATIENT PROCEDURES, APPOINTMENTS & FEE SCHEDULE

Synergy requires a minimum of 2 weeks between the blood draw and your appointment. If you choose to use an external draw center, such as Sonora Quest or LabCorp, it is your responsibility to ensure that the labs are completed at least 2 weeks prior to your appointment. If labs are required and not completed on time, the appointment will be canceled, which may disrupt your medication needs.

Tardiness, Late Cancellation or No-Show policy | Synergy schedules 15-minute overlapping appointments to ensure the flow of the doctor’s schedule, to avoid running behind. This means, you will need to arrive at the scheduled time to complete paperwork and vitals prior to seeing the doctor. Synergy requires a 24-hour notice prior to the appointment time to make changes. Leaving a message is acceptable on days the office is closed. No call/no show results in a fee for all appointment including BLOOD DRAW APPOINTMENTS. Note that the patient will not be able to reschedule until the fee is paid which can potentially disrupt medication refills, procedures in care.

  • Late Cancellation Fee $50

  • No call/no show Fee for Blood Draw Appointments $25

  • No call/no show Fee for Appointments $100

Credit/debit Card on File | Each patient will be given a Credit/Debit Card Authorization Form that will be kept securely in the patient’s chart. It is the patient’s responsibility to maintain updated information. If the payment is bounced, returned or unable to be completed, an $25 fee will be added to the cost and unable to schedule an appointment.

  • The credit/debit card on file will be utilized to pay for appointment deposits.

  • The credit/debit card on file will be utilized to pay for phone appointments.

  • The credit/debit card on file will be utilized to pay late cancellation or no-show fee.

  • The credit/debit card on file can be utilized to speed up the checkout process.

Prescription Refill Requests | If you require a prescription refill, please contact your pharmacy to request it at least 2 weeks prior to running out of your medication. If there are no refills available, an appointment with your physician may be necessary. Please note that processing prescription refills will take several days for physician authorization before the pharmacy can fill them. Refill requests made with fewer than 7 days remaining on the prescription will be considered an "emergency refill" and are subject to a $100 fee. Additionally, Synergy Restorative Medicine does not provide services for "prior authorizations" for any prescriptions, labs, imaging, or office services.

  • Emergency Refill Fee $100

Email, Texting Rule, & Messages | Consultations and prescription requests cannot be done via email or text messaging. Questions or clarifications for recent visits will be answered through a Staff member. Lengthy questions pertaining to medical concerns may be redirected to make an appointment with the Physician. Messages left for the physician will be returned within 5 business days.

Unattended Children Rule | Children under the age of 16, cannot be left unattended in the wait area. If childcare arrangements cannot be made and your child is unable to accompany you during the appointment, please call the front desk at least 24-hour prior to your appointment to reschedule. Parents will be responsible for any damages that may occur.