Payment is due at the time of service. Payment methods accepted: Cash, Check, Visa, MasterCard, Discover and American Express. Payment plans are available for programs and packages.
INSURANCE & MEDICARE
No insurance is accepted, processed or billed by BioHealth Ohio. If you would like to submit your visit to insurance, BioHealth will gladly print a receipt for payment received and services rendered at that time that you may submit on your own. All insurance matters are strictly between you and your insurance company and you understand that BioHealth does not speak to insurance companies on your behalf. Therefore, BioHealth does not fill out any specific paperwork or respond to any mail sent to their office. Since the office does not accept Medicare, no receipts from BioHealth Ohio may be submitted to Medicare at any time for any reason.
FINANCIAL RESPONSIBILITY & BILLING
You acknowledge all financial responsibility for yourself (or guardian relationship) for services or products rendered under BioHealth Ohio.
OUTSTANDING ACCOUNT BALANCE
I understand that if there is any outstanding balance on my account for longer than 30 days, then I will be responsible for any expenses incurred in the collection of my account. Any accounts that become 45 days delinquent will be subject to a finance charge of 1.75% per month (21% APR). Any accounts that become more than 60 days delinquent will be referred for assignment to our collection agency. All additional charges equal to the cost of collection including agency and attorney fees and court costs incurred and permitted by laws governing these transactions will be added to the amount due.
There is a $35 fee for returned checks for non-sufficient funds.
CANCELLATIONS / NO CALL NO SHOWS
BioHealth Ohio tries to be flexible and accommodating regarding any needs to change an appointment, but cancellations without at least a 24-hour notice and no-call/no-shows are subject to a $95 fee that must be paid before another appointment will be put on the schedule. For recurring instances, you may be required to pay in full prior to your visit. If the problem persists, patients could be dismissed from the practice.
In order for Dr. Siegel and his staff to give his best care to all patients, they must allow enough time to complete the needed services and recommendations for each appointment. Therefore, they must adhere to the appointment times as scheduled. If you arrive more than 10 minutes late, your appointment will need to be rescheduled and is subject to a $95 fee. We still have to adhere to our late policy regardless of traffic or weather situations.
You understand that within your regular Toxicology visit, Dr. Siegel will only advise on dosages of nutritional supplements that he has recommended. You understand that you cannot bring in supplements that you have got on my own or from another practitioner for Dr. Siegel to test during a Toxicology visit. You understand that if you wish to have any additional supplements tested, you must schedule a separate visit for that specific service to be performed at an additional cost.
In order to protect the testing vials, all cell phones must be completely POWERED OFF before entering Dr. Siegel’s office. Airplane mode, silent and vibrate are not acceptable options alternatives.
In an effort to keep your costs down, your treatment vials are re-used for each treatment and you must bring treatment vials back to each appointment or there will be a $20 replacement charge for vials that are lost or forgotten.
QUESTIONS REGARDING YOUR TREATMENT PLAN
During your scheduled appointments you am encouraged to ask questions about your treatments. However, if after your appointment you have questions or symptoms pertaining to your care at BioHealth Ohio, you can contact the office by an online portal via the website. If there is a need for longer discussions regarding new symptoms or questions, there will be a fee for additional time or Dr. Siegel may ask that you schedule a follow-up appointment. Dr. Siegel does not directly answer phone calls. Staff is fully trained to answer most of your questions.
If you need to relay information to Dr. Siegel, patients will complete the patient communication form found on the website. It is understood that BioHealth Ohio does their best to get an answer to our patient’s as quick as possible (within 48 business hours), however, most the time questions are answered in between appointments.
Any specialty lab tests are usually an out of pocket expense.
HIPAA; NOTICE OF PRIVACY ACT
HIPAA stands for the Health Insurance Portability and Accountability Act of 1996. A major component of HIPAA addresses the privacy of individuals’ health information by establishing information and how it can be used and disclosed. The document also states how protected health information may be disclosed to receiving payment/reimbursement through insurance.
You hold BioHealth Ohio/Dr. David Siegel, DC CCN DACBN harmless for any claims or damages in association of your work together.
What you discuss with BioHealth Ohio/Dr. David Siegel, DC CCN DACBN will be treated confidentially in accordance with law and recognized professional standards.
Dr. Siegel does not diagnose or treat cancer, but his methods are effective for helping one’s immune system.
DR. SIEGEL’S RECOMMENDATIONS
If a patient does not follow all of Dr. Siegel’s recommendations, results can take longer to achieve. You must actively participate in your treatment at BioHealth Ohio such as making recommended lifestyle and or dietary changes.
EMERGENCIES AND AFTER-HOURS CARE
In the event of a health emergency or urgent health problem, contact 911 or go to the nearest hospital emergency room.
Dr. Siegel’s methods of diagnosis and treatments are unique, and he does not accept every person into his programs.
Dr. Siegel does not write letters of disability or associated forms.