Radiance Ketamine Clinic
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Terms & Conditions

GENERAL INFORMATION

APPOINTMENTS AND SCHEDULING

Our commitment to you is that you will be offered the next available appointment to see one of our providers.

You may also schedule an appointment online by clicking here.

INSURANCE CARDS

We will need to see your insurance card(s) and a photo ID every time you are seen in our office. We are unable to process your insurance claim without them. If you cannot provide proof of insurance at the time of service, you will be considered a self-pay patient. Any insurance co-pay or co-insurance is due when you register. Please let us know if there are any changes to your insurance coverage or plan.

PLEASE BE ON TIME FOR YOUR APPOINTMENT

  • New patients: Please arrive 30 minutes early to complete any necessary paperwork and to allow for verification of insurance.

  • Established patients: Please arrive 15 minutes early to complete your registration.

PLEASE FILL OUT ANY DOCUMENTS EMAILED TO YOU PRIOR TO YOUR APPOINTMENT

Upon scheduling a new appointment, some forms will be automatically emailed to you. Please fill them out prior to your appointment. The sooner that you are able to submit them, the sooner that we can start getting things ready for your appointment. Some forms may need to be printed and filled out manually. Please bring these documents with you to your next appointment.

MEDICATIONS

Please bring a list of all medications (name, dosage and frequency), including herbal and over-the-counter medications to every appointment.

TELEPHONE MESSAGES

We receive a high volume of telephone calls every day. We will make every effort to return calls as soon as our schedule allows. If you leave a message, please leave a phone number where you can be reached during business hours.

AVOID DISTRACTIONS

Please refrain from cell phone use while our staff are assisting you.

VIDEO SURVALLENCE

Due to the presence of controlled substances at the clinic, we have implemented the use video cameras in certain patient care areas. In addition, video cameras may be used to improve patient monitoring during medical treatments. Video recordings will only be accessible to authorized clinic personnel and may also be released to authorized representatives of an investigating agency and/or pursuant to a valid subpoena or court order. Video recording will never be performed in situations where a patient is not fully clothed. We require a signed consent allowing video recording prior to receiving treatment at our clinic. We are more than happy to discuss any questions that you may have regarding this policy and why it is important.

FINANCIAL POLICY

Radiance Ketamine Clinic is committed to providing you with the best possible service and medical care. Your complete understanding of your financial responsibilities is an essential element of care and treatment. If you have special needs, we are here to work with you. The following information is provided to avoid any misunderstanding or disagreement concerning payment for professional services.

REGARDING INSURANCE

We accept many insurance plans and will bill your insurance company directly as a courtesy. If your insurance payor doesn’t cover medical care deemed necessary by your physician, you will be 100% responsible for those charges. It is your responsibility to:

  • Bring your insurance card to every visit.
  • Be prepared to pay your co-payment at each visit. Payment can be made by cash or credit card.
  • For medical care not covered under insurance, the estimated payment in full is due at the time of the visit.

Please remember that some insurance companies pay fixed allowances for certain procedures and others pay a percentage of the charge. It is your responsibility to pay any deductible amount, co-insurance or any other balance not paid for by your insurance.

NON-COVERED SERVICES

It is your responsibility to know your insurance coverage benefits and to present your card at each visit. We cannot be responsible if services are not a covered benefit on your insurance plan.

NO INSURANCE COVERAGE

If you do not have insurance coverage, you are required to pay the estimated charges at the time of service. If you are unable to pay for necessary medical care, you may be eligible to participate in a payment plan. We offer CareCredit. It is your responsibility to inform us of this prior to your visit. Radiance Ketamine Clinic firmly believes that a good patient/physician relationship is based upon understanding and good communication. Questions about financial arrangements should be asked prior to services provided.

CHANGE IN INSURANCE PLANS

We ask you to update your insurance and demographic record at each visit to our office. It is your responsibility to notify us immediately of any changes. If we are unable to process your claim due to incorrect information or your claim is denied because of incorrect information, we will bill you directly for our services.

PAYMENT IS REQUIRED AT THE TIME OF SERVICE

If a co-payment is required by your insurance company, it is payable at the time of service.

REFERRALS

It is your responsibility to bring any referrals for treatment at or prior to your visit.

MINORS

We cannot see a minor without an accompanying parent, guardian or adult with written consent from the parent or legal guardian. If the patient is a minor (younger than 18 years) and is unaccompanied by a parent or guardian, we must have a written release/permission from the parent or guardian. The parent, guardian or unaccompanied minor is responsible for any payment due at the time of service, bringing the necessary referrals and the insurance card. Spravato has not been tested on those less than 18 years of age and is, therefore, not approved for this age group.

WE ACCEPT

Cash, Visa, MasterCard, Discover and American Express credit cards. We also accept CareCredit.

NO-SHOW FEE

We charge a $75 fee if you cancel within 24 hours or do not show up for an appointment.

THANK YOU

Radiance Ketamine Clinic firmly believes that a good patient/physician relationship is based upon understanding and good communications. Questions about financial arrangements should be asked prior to services provided. If you have questions about your insurance, we are happy to help you, please call 775-432-1500. Specific coverage issues, however, should be directed to your insurance company member services department (number is on the insurance card).

PRACTICE POLICIES

You will be evaluated by a trained and licensed provider. We wish to take this opportunity to welcome you and also to state some basic principles we believe essential in establishing a good relationship between us. Please read through this information, asking questions as needed.

1. INITIAL INTERVIEW:

Your first history and physical is considered an evaluation interview and exam. At the time of this appointment, the following decisions will be made with you:

  • If ketamine/Spravato/IV nutritional therapy is an appropriate treatment option
  • Frequency of treatment
  • Goals of therapy (what you hope to gain from this process.)

2. APPOINTMENTS:

Each appointment varies in length depending on your chief complaint. Typically, mental health conditions require a 40 min infusion appointment. The total time for the appointment is generally around 1.5 hours nerve pain conditions are generally treated with a 4-hour infusion, for a total visit time of around 5-6 hours. For Spravato, it is required that you will be monitored for 2 hours after administration. At the end of each appointment you can make arrangement for your next appointment or you may also book all of your prescribed appointments at once. For IV nutritional therapy, the length of the visit depends on the treatment that you are receiving.

3. CANCELLATIONS:

If you find that you need to cancel an appointment, please give as much notice as possible so that we can schedule people that are on our waiting list. You may be personally charged $75 for your appointment if not canceled at least 24 hours in advance other than for emergency reasons.

4. PAYMENTS:

If you do not have insurance coverage, you are required to pay the estimated charges at the time of service. We accept many insurance plans and will bill your insurance company directly as a courtesy. If your insurance payor doesn’t cover medical care deemed necessary by your physician, you will be 100% responsible for those charges. It is your responsibility to know your insurance coverage benefits and to present your card at each visit. We cannot be responsible if services are not a covered benefit on your insurance plan. We ask you to update your insurance and demographic record at each visit to our office. It is your responsibility to notify us immediately of any changes. If a co-payment is required by your insurance company, it is payable at the time of service. We accept Cash, Visa, MasterCard, Discover and American Express credit cards. We also accept CareCredit.

5. INSURANCE:

Insurance is an agreement between you and your insurance company as to how treatment will be paid for. Some insurance companies will pay for a portion of outpatient ketamine infusion services. In addition, some insurance companies will cover Spravato treatment, as long as your meet the prerequisite criteria. You should check with your insurance company’s representative to find out specific requirements and limitations of this coverage. If your insurance company requires that outpatient ketamine infusion services be preauthorized, it is your responsibility to initiate the preauthorization process, i.e. contacting your primary care physician, insurance company, or a third party “gate keeper”. Failure to obtain required preauthorization for outpatient mental health services will result in you being held 100% responsible for all charges.

6. CONFIDENTIALITY:

All information regarding the specific nature of your treatment is maintained at RADIANCE KETAMINE CLINIC and is considered confidential within the office unless specified by you in writing. However, each provider at this office reserves the right to use specialty consultation with other medical providers at the office as deemed necessary. We follow HIPAA and maintain confidentiality.

Feel free to contact us with any questions that you may have.