Office Policies

By attending our treatments, you agree to the following:
 

• All patients must recognize that they are responsible for the charges they incur for physical therapy, or for other services offered at MFR Physical Therapy, LLC
   

• Missed appointments are a loss for everyone.  Cancellations without adequate notice take time from other patients, thus they are subject to a $25.00 late cancel/no show fee.  Therefore, we require that you notify us a minimum of 12 hours in advance if you are unable to attend a scheduled appointment.  If you are 15 minutes late or greater, the therapist will have the option of seeing you or rescheduling.  Checks that are returned for any reason are subject to a $35.00 service fee.
   

Insurances   

• At this time we are accepting Medicare Insurance, however, each individual is responsible for their individual plans deductibles, and or co-pays.  For those that have other Insurance companies, we will provide the necessary documents to you, the patient, so that you may file a claim with your insurance company, and then be reimbursed directly by your insurance company.
   

• Medicare Patients:  We bill our standard fees to Medicare, they pay 80% of their allowable fees, and the difference is billed to your secondary insurance.  If you do not have secondary insurance or your secondary insurance denies payment, you will receive a statement following the receipt of Medicare's allotment.  Unless other arrangements are made, you will be responsible for the remaining 20% of the Medicare allowable rate.
   

• I understand that I remain personally responsible for the amounts due to this office for their services.  I further understand and agree that this assignment and authorization does not constitute any consideration for the office to await payments and they may demand payments from me immediately upon rendering services at their option.
   

• I authorize this office to release any information pertinent to my case to any insurance company, billing service, adjuster, or attorney to facilitate collection under this assignment and authorization.