All charges incurred for services in the office will be payable at the time of service unless other arrangements are made.

All co-payments, deductibles or outstanding balances are due upon arrival to the office.

The deductible and co-pay may be required in advance for all surgeries.  All elective procedures not covered by insurance must be paid in full prior to the surgery unless other arrangements are made.

All contraceptive devices or injections (including Essure, IUDs, and DepoProvera) furnished at the office are to be paid at the time of service.

All OB patients are required to pay any portion of the delivery fee not covered by insurance by 28 weeks.  OB patients are also required to pay promptly for any other services provided during the pregnancy.  Care may be discontinued for non-compliance.

The responsibility for payment of service is with the person seeking treatment or the person seeking treatment for another.  Any court ordered responsibility judgment must be determined between the individuals involved without the involvement of this office.

All patients seeking infertility services must furnish a statement from their insurance company regarding infertility benefits before service is rendered.  All services not covered by insurance must be paid in full at the time of service.

All patients having insurance requiring a referral for OB/GYN services will be required to present the referral before services are provided.  Any patient seeking service without a referral must pay for the service in advance or reschedule the appointment.

Any delinquent account that is not collected from the patient will be turned over to a collection agency.  In this event, payment in full will be required for any further services, regardless of insurance coverage.  You will also be responsible for any court costs, attorney fees or any other fees involved in the collection of the account.

Dr. Carolyn Thompson may discontinue care due to noncompliance with the recommended care or for non-payment.

Patients with missed appointments or short-notice cancellations (under 24 hours) may be charged a fee of $25.

Please note that all blood work and pathology charges will be billed by the lab.  If any questions arise for non-payment from your insurance company, please call the number on the LAB statement.

ADMINISTRATIVE FEES

$25.00 fee for FMLA paperwork, account ledger charges, letters to insurance companies or other facilities.

$15.00 fee for patient records; $10.00 additional fee per set for multiple copies

$25.00 fee for no-show appointments

$25.00 service charge on all returned checks

©  2016 by Thompson Gynecology, 2201 Murphy Ave. Suite 310, Nashville, TN 37203. (615) 341-0991. All Rights Reserved.