Financial & Insurance Policy
Thank you for choosing Dr. Loop, OMD for your care. A clear financial agreement supports mutual respect and allows care to proceed smoothly and without distraction. Please review the following policy carefully. Acknowledgment of this policy is required prior to beginning treatment.
Fees & Payment
Fees are based on the time, complexity, and clinical care provided during each visit. Payment is due at the time of service unless prior arrangements have been made.
Insurance Billing
As a courtesy, this office will verify insurance benefits and submit claims when possible. Verification of benefits does not guarantee payment.
If insurance coverage cannot be verified prior to your appointment, payment will be required at the time of service until verification is obtained.
Please note:
- This office is not a party to your insurance contract.
- You are responsible for providing accurate and complete insurance information.
- You are responsible for all charges not paid by your insurance carrier, including co-pays, co-insurance, deductibles, and non-covered services.
By receiving care, you authorize:
- Assignment of insurance benefits directly to Dr. Loop, OMD for services rendered.
- Release of necessary medical information to your insurance company, adjuster, or attorney for claim processing.
- Storage of a credit card on file for balances not paid by insurance.
You may revoke authorization in writing at any time.
Usual & Customary Rates (UCR)
Fees reflect usual and customary rates for this region. Some services may be considered non-covered or not medically necessary by insurance carriers. Any denied or unpaid charges remain the patient’s responsibility.
Billing Options
Please select one billing option. Chanes require completion of a new financial authorization form.
Option 1: Private Pay
Discounted private-pay rates apply only when payment is made at the time of service.
Option 2: Insurance Billing (Medical or Auto)
By choosing insurance billing, you agree that:
- All co-pays, co-insurance, deductibles, and non-covered services are due at check-in.
- Verification of benefits is not a guarantee of payment.
- Any unpaid patient balance will incur a $10 monthly billing fee.
- Balances unpaid after 90 days may be sent to collections unless prior arrangements are made.
Appointment Policies
This practice honors presence, preparation, and mutual respect for time, but understanding is made due to true emergencies and sickness.
Cancellations & Rescheduling
A minimum of 24 hours’ notice is required to cancel or reschedule an appointment.
- Appointments canceled with less than 24 hours’ notice are charged at 50% of session fee
- If Dr. Loop must cancel, every effort will be made to provide at least 24 hours’ notice.
No-Shows
Missed appointments without notice are considered no-shows and are charged in full. No-show appointments are non-refundable.
Late Arrivals
Late arrival may result in a shortened session in order to accommodate subsequent appointments.
Full session fees apply regardless of shortened treatment time.
If insufficient time remains to provide care, the visit may be rescheduled.
Refund Policy
All services, packages, and purchases are non-refundable. If a charge was made in error, prompt communication with the office is appreciated.