OUR POLICY requires payment at the time of service. This is a cash pay only practice. You are allowed to submit paperwork from Wholesome Health, LLC to your insurance provider, but there is no guarantee they will reimburse you from services rendered. Wholesome Health, LLC, will: • Assist the patient in gathering the proper documentation so they can file the claim which includes detailed statement summary, proper ICD-9 and CPT codes. • We gladly accept cash, credit card and personal checks with proper identification. (Please note: A $25.00 overdraft charge will be added to all returned checks). Missed appointments: you may be charged a no-show fee of $100.00 for a missed appointment. When you bill remains unpaid, a collection agency may be chosen to manage delinquent accounts. If your account is placed with a collection’s agency, the patient will be charged a 30% surcharge. The patient is solely responsible for all costs of collections. Thank you for choosing Wholesome Health, LLC for your healthcare needs! I have read and fully understand my financial responsibilities under this policy.