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Financial Policy

Dear Patient,

Welcome to The WellBridge Clinic. We work to provide you with the best health care possible. To assist you in understanding finances and medical care, we ask that you please read the following information regarding our Financial Policy for payment, services, and missed appointments.

Payment of Services
Payment is expected at the time of the visit unless other arrangements have been made in advance. We can bill most forms of health and Personal Injury insurance. We require you to provide your complete and correct insurance information before your first appointment. Alternatively, your payment is due at the first visit if you do not provide insurance benefits.

We use a billing company, Efficient Medical Billing Services (EMBS) for insurance billing. They may contact you for copays, balance due, or any billing issues. Our Patient Care team does not complete your insurance billing or collections for any unpaid balance.

You are responsible for understanding your insurance benefits and cost. We have provided a “Patient Checklist for Insurance Benefits” to help you understand your insurance.

Be aware that some fees are not known until after the claim has been processed. Examples of these fees: deductibles, copayments, coinsurance, or patient responsibility in amounts not known to the clinic or you at the time of your visit. If you find this unjust or obstructive to accessing your health care benefits, we strongly encourage you to file a complaint to the State of Oregon Department of Consumer and Business Services on their insurance complaint page or call 503-947-7984.

Car Accidents and Worker’s Compensation Claims
We provide medical services and bill insurance for people injured in car or work accidents. We will always check your benefits and communicate with your claim adjuster and legal team. If the medical services provided are unpaid by the involved parties, the patient will be responsible for the cost of medical care. If you are working with a lawyer, please provide us with their contact information. We will require a signed letter of protection on file.

Missed Appointments
When you are scheduled for an appointment, that time is reserved for you. We do our best to be on time and we value your time. If you must change your appointment, we require 48 hours’ notice of your appointment change. The fee for cancelled or missed appointments is as follows: New patients is $150 and existing patients is $100. Be aware that insurance companies only pay for health care services rendered and do not cover these fees.

You will receive reminders for your appointments with Text Messages and Email Reminders. Please remain subscribed to your email and text reminders.

Credit Card on File
We require all patients to have a credit card securely held on file. In the event of a late cancel (less than 24 hours) or a no-show to your appointment, your card will be automatically charged the cancellation fee. Please reference fees listed above.

Unpaid Balances
Any balances outstanding beyond 3 months will accrue a monthly finance charge at a rate of 1.5%. For extended outstanding balances, our billing company will seek payment. If payment is not received they will submit the outstanding balances to a collection agency.

You can download and print this form for your files. Alternatively, please ask one of our patient care team members for a copy.

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