Policies

 

Privacy Policy

 

Notice of Privacy Practices

Effective January 1, 2015

 

please read the following policy in place:

 

 

 

Insurance Authorization Policy

 

There is no guarantee that your insurance company will pay for all services rendered. Any medical services not covered by an individual’s insurance plan are the patient’s responsibility and payment in full is due at the time of the visit. If we have not received the payment within 45 days we will notify you and unpaid balances will become your responsibility, and we will expect in full at that time. It is the patient’s responsibility to pay any deductible or any portion of the changes as specified by the plan at the time of the visit.

 

As a courtesy to our patients, Tricities Medical Weight Loss Center / Keep Weight Off makes considerable effort to verify insurance coverage and provide an estimate of what insurance will pay for services from information we receive from each patient’s insurance representative. Please be informed that such information is NOT an official or legally binding estimation of your out of pocket expenses. The final cost share is dependent on the decision of the insurance carrier. It is also possible that any co-pay estimate given prior to your examination may turn out to be different from the final decision of your insurance carrier. In that case the patient will be directly and fully responsible for payment for all charges, including any amount of previous co-pay estimates.

 

Please note: It is the patient’s responsibility to ensure that any required referrals for treatment are obtained before the visit or the patient may be financially responsible due to lack of the referral at the time of the service.

 

For medical weight loss, patient is advised to verify their coverage before the visit, specifically in reference to preventative medical weight loss coverage, BMI threshold and number of counseling covered per their plan.

 

 

 

 

Financial Policy

 

Recognizing the need for patients to understand what is expected regarding payment of medical services, we have established our financial policy. Some of these are required by law. It is our goal to remain sensitive to our patient needs while providing quality medical care, and we encourage you to contact our office if a problem should arise regarding your account.

 

please read the following policy in place:

 

 

 

 

Appointment Policy

 

Patients failing to attend scheduled appointments otherwise, known as a ‘NO SHOW’, hinder our ability to assist in a timely manner. To overcome the issue, please read the following policy in place:

 

 

 

Communication Policy

 

All communication regarding a patient's health care, must be made through or by the resources we've listed in the policy.

 

You can contact our staff by phone, email, or fax. please read the following policy in place:

 

 

 

Verjú Laser Consent and Treatment Policy

 

CONSENT & LIABILITY RELEASE FORM

 

 

Verjú Treatment RELEASE FORM

 

 

 

Dr. Nadia Malik

Internal Medicine and Bariatrics

Call Us Today For A Better You.

Contact Info

4100 Heritage Ave

Suite 102

Grapevine, TX 76051

682-999-8446

817-545-4438

service@keepweightoff.net

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(682) 999 8446 (THIN)

 

service@keepweightoff.net

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INTERNAL MEDICINE AND MEDICAL BARIATRICS

NADIA MALIK, MD