Effective Date: 06/27/2026
At Advanced Practice Nursing Specialists (“APNS”), we are committed to providing transparent pricing and high-quality medical care. This Financial Policy explains your financial responsibilities, our payment policies, and the services that are and are not included with your appointment. By scheduling an appointment, registering as a patient, or receiving services from APNS, you acknowledge that you have read, understood, and agree to this Financial Policy.
Cash-Pay Medical Practice
APNS is a cash-pay, fee-for-service medical practice. We do not participate in, contract with, or bill commercial insurance plans, Medicare, Medicaid, TRICARE, or other third-party payers for medical services unless specifically stated otherwise for a particular service or jurisdiction.
Payment is required at the time services are rendered unless other arrangements have been approved by APNS in writing.
Because APNS operates outside of the traditional insurance model, our providers are able to spend more time focusing on patient care rather than insurance requirements, billing regulations, and administrative processes.
Payment for Professional Medical Services
Your appointment fee compensates APNS for the provider’s:
- Professional medical time
- Clinical expertise
- Medical knowledge and experience
- Review of your medical history
- Clinical evaluation
- Medical decision-making
- Documentation
- Care planning
- Professional recommendations
Payment is for the provider’s professional services—not for a guaranteed diagnosis, prescription, laboratory order, imaging study, referral, requested medication, or specific medical outcome.
Medical decisions are based solely upon the provider’s independent professional judgment and accepted standards of medical practice.
Patient Financial Responsibility
Patients are solely responsible for all costs associated with their healthcare, including but not limited to:
- Office visits
- Telehealth visits
- Follow-up visits
- Prescription medications
- Compounded medications
- Laboratory testing
- Diagnostic imaging
- Specialist consultations
- Medical procedures
- Durable medical equipment (DME)
- Medical supplies
- Vaccinations
- Services provided by outside healthcare providers
- Pharmacy dispensing fees
- Shipping charges
- Any additional costs incurred through third-party vendors
Fees charged by pharmacies, laboratories, imaging centers, hospitals, specialists, or other healthcare providers are separate from APNS fees and are the patient’s responsibility.
Insurance, Reimbursement, and Superbills
Because APNS is a cash-pay practice, we do not submit claims to insurance companies.
Upon request, APNS may provide an itemized receipt or superbill that patients may independently submit to their insurance company, Health Savings Account (HSA), Flexible Spending Account (FSA), Health Reimbursement Arrangement (HRA), or other benefit administrator.
However:
- APNS makes no representation or guarantee that any service will be covered or reimbursed.
- Insurance coverage varies by plan.
- Reimbursement decisions are made solely by your insurance company.
- Patients are responsible for determining their own eligibility for reimbursement.
Any reimbursement received from an insurance company belongs solely to the patient.
Insurance Prior Authorization Policy
Because APNS is a cash-pay, fee-for-service practice, APNS does not obtain, submit, process, monitor, appeal, or otherwise participate in insurance prior authorizations (“PAs”) for:
- Prescription medications
- Compounded medications
- Injectable medications
- Laboratory testing
- Diagnostic imaging
- Durable medical equipment (DME)
- Medical supplies
- Procedures
- Referrals
- Specialty medications
- Any other healthcare service or product
APNS also does not:
- Contact insurance companies regarding benefits or coverage;
- Submit or respond to prior authorization requests;
- Complete insurance medical necessity forms;
- Participate in peer-to-peer reviews;
- Appeal insurance denials;
- Submit letters requesting insurance approval;
- Investigate prescription coverage;
- Determine formulary status;
- Request coverage exceptions; or
- Communicate with insurance companies regarding claims, reimbursement, benefits, or payment.
If your insurance company requires prior authorization or approval before paying for a medication, treatment, laboratory study, imaging study, medical equipment, or other healthcare service, you are responsible for working directly with your insurance company, pharmacy, supplier, or another healthcare provider who participates with your insurance plan.
Insurance coverage decisions are made exclusively by your insurance company and are completely independent of APNS’s medical recommendations.
Pharmacy Responsibility
Patients are free to choose the pharmacy of their choice.
Once a prescription has been issued, APNS is not responsible for:
- Pharmacy pricing
- Medication availability
- Inventory shortages
- Shipping delays
- Insurance coverage
- Pharmacy processing times
- Pharmacy business hours
- Medication substitutions made by the pharmacy
- Pharmacy policies
- Compounding delays
Questions regarding medication cost, insurance coverage, shipping, availability, or pharmacy policies should be directed to the dispensing pharmacy.
Laboratory, Imaging, and Third-Party Services
APNS may recommend laboratory testing, imaging studies, consultations, or other healthcare services when medically appropriate.
These services are performed by independent third-party providers.
APNS is not responsible for:
- Scheduling delays
- Insurance coverage
- Pricing
- Billing
- Collection activities
- Testing availability
- Turnaround times
- Facility policies
Patients are responsible for all charges associated with third-party services.
No Guarantee of Treatment or Prescription
Payment for a medical evaluation does not guarantee that:
- A prescription will be written;
- A requested medication will be prescribed;
- Controlled substances will be prescribed;
- Laboratory testing will be ordered;
- Imaging studies will be ordered;
- A referral will be provided;
- A diagnosis can be established;
- A requested treatment is medically appropriate; or
- A desired medical outcome will occur.
APNS providers prescribe medications and recommend treatments only when they determine they are medically appropriate, safe, and consistent with current standards of care and applicable laws.
Refund Policy
Appointment fees compensate providers for their professional time and medical expertise. Accordingly, appointment fees are generally non-refundable once the provider has begun reviewing your medical information or initiated the medical evaluation.
Refunds will not be issued under the following circumstances:
- Missed appointments or “no-shows.”
- Failure to attend a scheduled telehealth appointment.
- The provider determines that a prescription, laboratory test, referral, or requested treatment is not medically appropriate.
- The provider determines that your condition requires in-person evaluation or referral to another healthcare provider.
- The provider determines that treatment cannot legally or safely be provided.
- You disagree with the provider’s diagnosis, recommendations, or treatment plan.
- Your insurance does not cover recommended medications or treatments.
- A pharmacy is unable to fill your prescription.
- Medication shortages or manufacturer backorders.
- Delays caused by pharmacies or third-party vendors.
Refunds also will not be issued if a provider terminates a visit because of inappropriate patient conduct, including but not limited to:
- Inappropriate attire during a video visit;
- Profanity or abusive language;
- Threatening, intimidating, discriminatory, or harassing behavior;
- Sexual or inappropriate conduct;
- Refusal to follow reasonable provider instructions;
- Recording providers or staff without permission where prohibited by law; or
- Any behavior that compromises the safety or professionalism of the medical encounter.
Appointment Cancellations and Technical Issues
If APNS must cancel your appointment before your medical evaluation begins because of provider availability, scheduling issues, or a technical problem originating from APNS’s systems, APNS may, at its sole discretion, either:
- Reschedule your appointment; or
- Issue a full refund.
Patient Technology Responsibility
Patients are responsible for ensuring they have a functioning:
- Computer, tablet, or smartphone;
- Internet connection;
- Camera;
- Microphone;
- Speakers or headphones;
- Supported web browser;
- Operating system; and
- Any software necessary to participate in a telehealth visit.
Technical issues originating on the patient’s side—including internet connectivity problems, malfunctioning equipment, browser incompatibility, disabled camera or microphone permissions, dead batteries, unfamiliarity with the telehealth platform, or any other patient equipment or technology issue—do not qualify for a refund.
If a telehealth visit cannot be completed because of patient-side technical problems, APNS may, at its sole discretion, allow the patient to reschedule the appointment. However, because provider time has been reserved exclusively for the patient, refunds will not be issued due to patient equipment, technology, or internet-related issues.
Patients are encouraged to log in several minutes before their appointment and test their equipment to ensure a successful visit.
Chargebacks and Payment Disputes
Patients agree to contact APNS first regarding any billing concern or disputed charge before initiating a credit card chargeback or payment dispute.
Initiating a chargeback for services that were provided in accordance with this Financial Policy may result in suspension or termination of the patient relationship and may be referred for collection or legal remedies where permitted by law.
Policy Changes
APNS reserves the right to modify this Financial Policy at any time. Updated versions become effective immediately upon posting to our website or otherwise being made available to patients.
Acknowledgment
By scheduling an appointment, registering as a patient, completing intake forms, or receiving services from APNS, you acknowledge that you have read, understood, and agree to this Financial Policy, including APNS’s cash-pay practice model, payment requirements, refund policy, insurance limitations, prior authorization policy, and your financial responsibility for all services provided.