Cosmetic Center and Medical Spa Considerations
Thank you for your interest in R Medical Spa. Since each person has individual and unique concerns, we invite you to schedule a consultation with one of our physicians or skin care nurses to help customize a treatment plan that is right for you. Our practice is committed to providing you with the latest, most advanced technology to help you look and feel your best. We hope to exceed all of your expectations.
We accept American Express, Discover, MasterCard and Visa.
We respectfully request 24 hour notice for all cancellations.
We offer a variety of gift certificates perfect for any occasion. Our staff would be happy to assist you in selecting a customized gift for any person.
We welcome younger patients to receive treatment when accompanied by an adult. However, in order to maintain a quiet, relaxing atmosphere, we respectfully ask that children not accompany you to your appointment.
The surgeon & implant fees are to be paid, in full, two weeks prior to surgery. Forms of payment accepted: Cash, Personal Check, Money Order or Cashiers Check, and Credit Card (MasterCard, Visa, Discover and American Express). In order to provide you with the best scheduling options, it is important that we follow the policies listed below.
Scheduling of Surgery
A non-refundable 10% of the surgeon’s fee is required to confirm and hold the date of surgery.
Payment of Surgery
The surgeon and implant fees are to be paid in full two weeks prior to surgery. Forms of payment accepted: Cash, Personal Check, Money Order or Cashiers Check and Credit Card (MasterCard, Visa, Discover and American Express). The facility and anesthesia fees are to be paid as directed by the surgical facility. Surgeon’s pricing will expire 90 days from the date of the original surgical cost analysis. Facility and anesthesia pricing expires 30 days from the date pricing is given. *Refunds to a credit card will have a 5% processing fee on charges of $1,000 or more.
Rescheduling or Cancellation of Surgery
A $200 fee will be applied to reschedule a confirmed surgery date, greater than two weeks before surgery. The fee for cancellation or rescheduling within two weeks of surgery is 25% of surgeon’s fee. The fee for cancellation or rescheduling within 48 hours of surgery is 50% of the surgeon’s fee.
Additional charges will apply if other than the stated procedure(s) is performed or if the procedure takes longer than indicated. Revisions deemed necessary by the physician will be done at a reduced surgeon’s fee; facility and anesthesia fees will be your responsibility. If the revision can be completed in our office procedure room, the facility fee of $150 per hour will be assessed.
Disclosure Notice Regarding Patient Protections Against Surprise Billing
Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network providers at in-network facilites, holding them liable only for in-network cost sharing amounts. The No Surprises Act also enables uninsured or self-pay patients to receive a good faith estimate of the cost of care.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care–like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Additionally, Missouri protects patients from surprise medical bills for health care services provided at an in-network facility from an out-of-network provider from the time the patient presents with an emergency medical condition until the patient is discharged.
CERTAIN SERVICES AT AN IN-NETWORK HOSPITAL OR AMBULATORY SURGICAL CENTER
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
Additionally, Missouri law requires that patients pay only their in-network cost sharing amounts. These protections apply to any patient covered by a state regulated insurance plan but does not apply to a liability insurance policy, workers’ compensation insurance policy, or medical payments insurance issued as a supplement to a liability policy.
When balance billing isn’t allowed, you also have the following protections:
- You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
- Your health plan generally must:
- Cover emergency services without requiring you to get approval for services in advance (prior authorization).
- Cover emergency services by out-of-network providers.
- Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
- Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact:
- The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.
- If you believe that you have been wrongly billed, contact the Missouri Department of Insurance at 800-726-7390.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, healthcare providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment and hospital fees.
- Make sure your healthcare provider gives you a Good Faith Estimate in writing at least 24-72 business hours before your medical service or item. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
Get More Information
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).
Our Commitment to Your Privacy
Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information.
We realize that these laws are complicated, but we must provide you with the following important information.
Use and disclosure of your health information in certain special circumstances.
The following circumstances may require us to use or disclose your health information:
- To public health authorities and health oversight agencies that are authorized by law to collect information.
- Lawsuits and similar proceedings in response to a court or administrative order.
- If required to do so by a law enforcement official.
- When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help the threat.
- If you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate authorities.
- To Federal officials for intelligence and national security activities authorized by law.
- To correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official.
- For Workers Compensation and similar programs.
Your rights regarding your health information:
- Communications. You can request that our practice communicate with you about your health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. We will accommodate reasonable requests.
- You can request a restriction in our use or disclosure of your health information for treatment, payment, or health care operations. Additionally, you have the right to request that we restrict our disclosure or your health information to only certain individuals involved in your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat you.
- You have the right to inspect and obtain a copy of the health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to Renaissance Plastic Surgery, 145 St. Peters Centre Blvd, St. Peters, Missouri 63376, (636) 896-0600 .
- You may ask us to amend your health information if you believe it is incorrect or incomplete, and as long as the information is kept by or for our practice. To request an amendment, your request must be made in writing and submitted to Renaissance Plastic Surgery, 145 St. Peters Centre Blvd, St. Peters, Missouri 63376, (636) 896-0600 . You must provide us with a reason that supports your request for amendment.
- Right to a copy of this notice. You are entitled to receive a copy of this notice of Privacy Practices. You may ask us to give you a copy of this notice at any time. To obtain a copy of this notice, contact Renaissance Plastic Surgery at (636) 896-0600 .
- Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact Renaissance Plastic Surgery at (636) 896-0600 . All complaints must be submitted in writing. You will not be penalized for filing a complaint.
- Right to provide an authorization for other uses and disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law.
To our patients. This notice describes how health information about you, as a patient of this practice, may be used and disclosed, and how you can get access to your health information. This is required by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
If you wish to discuss your aesthetic desires with a plastic surgeon, schedule an appointment at Renaissance Plastic Surgery. Our surgeons have been sought out by patients seeking a St. Louis / St. Peters breast augmentation, tummy tuck, rhinoplasty and facelift surgeon.