MindBody Wellness Atlanta, LLC Financial Policy

Dear Atlanta Restorative Acupuncture patient, 

In order to serve you better, we have it found it necessary to implement the following policies.

Please read carefully each section below and sign your name at the bottom of this document to indicate that you understand and agree to these policies.

Thanks for for your patronage. We genuinely appreciate you.

Sincerely,

Dr. David Blake Jones, D.A.C.M., M.S.P.H., L.Ac.

Unless you have met an insurance deductible, payment in full or for co-pay is due for services and products at the time of the appointment. 

If you are using an insurance plan to cover any portion of your Acupuncture appointment and have paid for a visit that came AFTER a deductible had been met, you are entitled to an appropriate refund. You will receive in that refund the amount paid for Acupuncture beyond what you owed via co-pay. 

The current rate for first visit is a total of $156 and includes $98 for the first Acupuncture treatment, and $58 for the first office visit exam. Platinum LED Light Therapy is complimentary at first visit.

For Insurance patients ONLY: Whether you have met your deductible, you are charged an additional $3 (billing cost sharing charge as biller charges 6% per claim) for every claim filed. If a patient prefers not to pay this fee, he or she can opt for claims NOT to be filed, till the deductible has been met through care and filing of claims by other medical offices.

The current rate for follow-up visits is a total of $98, plus an additional $5 if you continue with PlatinumLED Light Therapy (warmer, and full spectrum Infrared device). If you do not want to pay the additional $5 for the light therapy, it is your responsibility to let us know so we can withhold that service during your treatment session.

Clear
This signature acknowledges that you have read and understod the terms.