Thank you for your interest in scheduling an appointment. The following is our Financial and Cancellation Policy that you must read and understand prior to booking your appointment. This is also contained in our Terms of Service which you agree to upon using our service. PLEASE BE SURE TO READ OUR TERMS OF SERVICE. IF YOU DO NOT AGREE TO OUR TERMS OF SERVICE, YOU MAY NOT USE OUR PLATFORM.

NEW PATIENT INITIAL CONSULTATION – REQUIRED

All NEW patients must consult with a licensed medical practitioner. The consultation includes a review of your medical history and determination of your medical eligibility for the treatment being requested.

The New Patient Initial Consultation Fee is $124.94 per 15 minutes.

To schedule an appointment, please complete the following:

1. Patient Registration Form on the Acuity App
2. Non-refundable $99.95 Scheduling Fee – applied towards the New Patient Initial Consultation Fee
3. It will be half the price plus $25.
   
4. Financial Policy Agreement

Simpel Drip is the management services provider for Deacon Medical Corp. (the “Medical Corporation”) which provides all medical services to customers. Simpel Drip collects payment on behalf of Deacon Medical Corp. and the health care professionals it employs and contracts with.

NO INSURANCE, NO MEDICARE, NO MEDICAID, NO SUPERBILLS. Simpel Drip and the Medical Corporation are not enrolled with, and are not participating providers with, any federal or state healthcare programs (i.e., Medicare, Medicaid) for the provision of any health care services or supplies and, as such, neither you nor Simpel Drip or the Medical Corporation may receive payment from such programs for the services or products provided to you by Simpel Drip or the Medical Corporation. Further, to the extent that any Providers may be enrolled in federal or state healthcare programs, the means through which the services and products are provided or made accessible through the Service typically precludes such services and products from being covered benefits under these programs. By choosing to use the Service, you are specifically choosing to obtain products and services on a cash basis outside of any federal or state healthcare program. Thus, you are solely responsible for the costs of any service or product provided to you.

We do not provide diagnostic codes or superbills.

By agreeing to use the Service, you acknowledge and agree that (1) you are explicitly choosing to obtain products and services on a cash basis outside of any federal or state healthcare program and you have sole financial responsibility for all services or products provided to you by or through the Service, and (2) neither you nor Simpel Drip, the Medical Corporation or the Providers will submit a claim for reimbursement to any federal or state healthcare program for the costs of the services and products provided to you through the Service.

Payment Due At Time of Scheduling and Time of Service. By booking an appointment for services through the Service, you agree to pay Simpel Drip the fee indicated for the booked service. Payments will be charged at the time of scheduling and time of service depending on the service you select. For example, for the required initial new patient consultation, you will be charged a non-refundable scheduling fee which will be used towards your new patient consultation. The new patient consultation is billed in increments of 15 minutes. For other services, payment in full may be due upon booking. Except as provided below under “Refunds and/or Credits”, the Services Fee is FINAL AND NON-REFUNDABLE.

You are responsible for making sure that your payment information remains accurate and up-to-date. Cancellations. WE REQUIRE AT LEAST 24-HOUR ADVANCED NOTICE OF CANCELLATION. You will be charged the full amount of the booked service should you not provide at least 24-hour advanced notice of cancellation. If you book your service less than 24-hours in advance, you may not cancel. Group appointments (parties of two (2) or more) follow the same parameters as single appointments and will be charged for all people booked unless you provide 24-hour advanced notice of any cancellations. For example, if you book a service for six (6) people, but only four (4) are present for the service with no 24-hour advanced notice for the other two (2) patients, you will be charged for all six (6) services. MISSED APPOINTMENTS ARE NON-REFUNDABLE.

If you call Simpel Drip and you reach our voicemail, leave your name and telephone number. We will call you back to confirm the message. IF YOU DO NOT GET A RETURN CALL, WE DID NOT GET YOUR MESSAGE.

Refunds and/or Credits.

If, at the time of your booked service, you are under the influence of drugs or alcohol, your medical professional will not perform the service and you will be charged the full amount and there will be NO REFUND.

In the event that the medical professional is unable to perform the booked services due to circumstances outside of the patient’s control or for reasons other than the patient’s medical condition or health, you will receive a full refund or credit. In the event that the medical professional is unable to perform the booked services due to (1) your current or previous medical history, condition, or reason, or (2) due to circumstances outside of the medical professional’s control after the insertion of the I.V. needle, you will receive a credit or refund for the full amount of the services scheduled, less a medical examination fee of one hundred dollars ($91.83).

Authorization to Charge. By using the Booking Services, you hereby agree Simpel Drip has the right and authorize Simpel Drip to automatically charge your credit card (or other payment method) for the applicable fees or charges, plus any applicable taxes. Misrepresentations. If, during the Booking Service process, you misrepresent yourself in any manner, including but not limited to, a misrepresentation of your age or medical history, Simpel Drip reserves the right to cancel your booked service without notice and charge you the full amount. Again, if, at the time of your booked service, you are under the influence of drugs or alcohol, Simpel Drip will not perform the service and you will be charged the full amount.