Life IV Weight Loss Billing and Financial Policy

Last Updated: March 25, 2025

This Billing and Financial Policy (“Billing Policy”) is incorporated by reference into the Terms and Conditions and governs your financial obligations and responsibilities when engaging with services provided by Life IV Therapy PLLC, doing business as Life IV Weight Loss (“Life IV,” “we,” “us,” or “our”). By receiving services from Life IV, you agree to the terms of this Billing Policy.

1. Financial Responsibility

You are financially responsible for all charges resulting from services rendered by Life IV. Payment is due at the time services are rendered unless prior written arrangements have been made. If you carry insurance, it is your responsibility to provide complete, accurate, and up-to-date insurance information before your visit. Life IV is not responsible for incorrect or outdated insurance information, and such errors may result in the patient being held fully responsible for all charges.

Life IV Weight Loss does not waive the use of insurance for any services or prescriptions that are contractually required to be billed through insurance carriers. We are not able to resubmit or backdate insurance claims for past visits if proper insurance information was not provided at the time of service.

2. Insurance and Coverage Limitations

Please be aware that not all services provided by Life IV may be covered under your insurance policy. Coverage varies greatly between insurers and benefit plans. Life IV cannot guarantee coverage for any services or prescriptions. It is the patient’s responsibility to know and understand their own benefit plan.

If a claim is denied by your insurance company or you have not met your deductible, you will be billed for the full amount due. Patients are responsible for any balance not paid by insurance within the allowable time frame.

3. Payment Terms

Balances not paid at the time of service are due within 30 days of the statement date. Accounts that remain unpaid after 60 days may be assessed a late fee or referred to a third-party collections agency. Continued non-payment may result in discharge from care.

Payment plans may be available on a case-by-case basis. Please contact our billing department before your due date to discuss options.

4. Statements and Communication

Billing statements are sent electronically or by mail and outline the services rendered, payments received, adjustments made, and remaining balance. If you believe your statement is incorrect or have questions, you must contact our billing team within 14 days of the statement date.

Failure to contact us within this window may result in the assumption that the statement is accurate and final.

5. Missed Appointments and Late Cancellations

Life IV requires at least 24 hours’ notice for appointment cancellations. Appointments canceled with less than 24 hours’ notice or not attended (“no-shows”) may be subject to a fee.

Multiple missed appointments without notice may lead to termination of services at our discretion.

6. Returned Payments

Any returned checks or failed payment transactions will incur a $35 fee. Repeated failed payments may result in additional restrictions on future services or require prepayment.

7. Collection Activity

In the event your balance becomes seriously delinquent (greater than 90 days past due), we may:

• Refer your account to a third-party collections agency;
• Report the debt to a credit bureau; and/or
• Suspend or discharge you from services at Life IV Weight Loss.

You are responsible for any additional fees incurred due to collection activity, including but not limited to attorney fees, court costs, and administrative expenses.

8. Updates to This Policy

We reserve the right to modify this Billing Policy at any time. Updated policies will be posted on our website with the new effective date. Continued use of our services after the posting of updates constitutes your acceptance of the revised terms.

9. Contact Information

If you have any questions about this Billing Policy or your account balance, please contact:

Billing & Insurance Team
📞 (517) 273-3210
📧 billing@lifeivtherapy.com