Clear Patient Disclosures
Working draft — for practice review
The visit fees below reflect the practice’s published pricing. Dr. Jones must review and adopt these disclosures and confirm payment timing, membership charges, cancellation and refund terms, and any insurance documentation offered before this page is treated as a final financial policy. This page is not a signed financial agreement.
Cash-pay care
Cash-pay care means you pay the practice directly for the services you choose. A cash-pay fee or membership payment is not a promise that your insurer will cover the service or reimburse you. Before care, confirm the total expected charges and how and when payment is due.
Coverage is not guaranteed
Visits, treatments, memberships, and specific specialized functional lab tests may not be covered or reimbursed by insurance. They may also be ineligible for HSA/FSA payment or reimbursement. A clinician’s recommendation does not, by itself, establish coverage or eligibility.
Cash-pay service fee schedule
- New Patient Consultation
- $400
- New Patient with Lab Review
- $450
- Follow-Up Visit
- $350
- Follow-Up with Lab or Results Review
- $400
These are visit fees, not an all-inclusive treatment or testing package. Confirm whether lab testing, specimen collection, procedures, IV therapies, medications, supplements, or other services carry separate charges. Fees for services not listed here must be confirmed with the practice before you authorize them.
For visit options, see visit information; for treatment options, see our services. Confirm current pricing before booking or purchasing care.
Transparent financial agreements
Before agreeing to services, request a written financial agreement that clearly identifies:
- The services included, their prices, and any services or third-party charges that are separate.
- When payment is due, any deposit or installment terms, and any authorization for recurring charges.
- Cancellation, rescheduling, missed-appointment, and refund terms, including any applicable fees.
- Your responsibility for charges if insurance or an HSA/FSA declines payment or reimbursement.
- How to ask billing questions or dispute a charge.
Review the agreement before signing and ask for a copy. Do not assume that a general website description replaces your specific agreement or cost estimate.
Membership-based care
A practice membership is not health insurance and does not replace coverage for emergency care, hospital care, specialists, or other services outside the membership.
Before enrollment, the written membership agreement should identify the enrollment and recurring fees, included visits or services, exclusions, extra charges, billing frequency, renewal terms, and how to cancel. Confirm whether unused benefits expire or carry over, and whether refunds are available. Do not assume testing or treatments are included unless the agreement specifically says so.
The SEED, ROOT, and THRIVE membership page describes the options and waitlist. Request confirmed pricing and final terms before enrolling; joining a waitlist is not a signed membership agreement.
Insurance coverage & reimbursement
Insurance benefits depend on your plan, network rules, deductible, medical-necessity requirements, and the particular service. Cash-pay functional medicine visits and treatments may be excluded or reimbursed only in part, if at all. Payment to the practice does not guarantee that the expense will count toward your deductible.
Ask your insurer about the specific service before proceeding. Confirm with the practice whether itemized receipts or other claim documentation can be provided; do not assume that a superbill or insurance claim filing is available. Even when documentation is available, it does not guarantee reimbursement.
You remain responsible for agreed charges if your insurer denies a claim or pays less than the amount charged.
Specialized functional lab tests
Specific specialized functional lab tests may not be covered by insurance, may be considered investigational or outside plan benefits, or may require out-of-pocket payment. Coverage for routine laboratory testing does not mean a specialized test is covered.
- Ask for the test name, performing laboratory, expected price, and any collection, shipping, or interpretation charges.
- Confirm who bills you — the practice, the laboratory, or both — and whether the quoted price includes a results-review visit.
- Ask your insurer and HSA/FSA administrator about that specific test before authorizing it.
- Discuss the test’s purpose, limitations, and alternatives with your clinician before deciding.
A test ordered by a clinician is not automatically covered by insurance or eligible for HSA/FSA reimbursement.
HSA & FSA use depends on the expense
Health savings accounts (HSAs) and flexible spending accounts (FSAs) can sometimes be used for qualified medical expenses, depending on the expense, applicable tax rules, and your account’s requirements. Eligibility is not the same as insurance coverage.
Some visits or tests may qualify; general wellness services, supplements, or membership charges may not. Membership eligibility can depend on the agreement’s structure and current rules. Certain expenses may require a prescription, a letter of medical necessity, or other documentation, and documentation alone does not guarantee approval.
Confirm eligibility with your account administrator and, when needed, a qualified tax adviser before using funds. Acceptance of an HSA/FSA card does not establish that a charge is eligible. Keep itemized receipts and any required documentation; you are responsible for how you use your account funds.
Know your expected costs before care
Request an itemized estimate before authorizing a visit, treatment plan, or specialized testing. Ask which charges are fixed, which could change, and whether other providers will bill separately. An estimate is not a guarantee of insurance reimbursement.
If you are uninsured or are not using insurance, federal law generally gives you the right to a Good Faith Estimate for scheduled medical services. Ask the practice about an estimate before care. If a provider’s bill is at least $400 more than that provider’s Good Faith Estimate, you may qualify for the federal patient-provider dispute process. Learn more at CMS: medical bill rights.
Questions before you commit
Contact us to confirm current fees, request financial terms or a cost estimate, or ask about documentation before booking, enrolling, or authorizing testing. For insurance or HSA/FSA eligibility, also contact your insurer or account administrator.
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