Patient financial policy.

When Cortina or your scheduled provider participates in your plan, we will submit eligible claims as required by law and applicable payer agreements. Please provide accurate, current insurance and contact information at each visit. Missing or incorrect information may delay processing or cause a claim to be denied.

Verification of benefits is not a guarantee of payment. Your insurer determines final coverage after processing the claim. You are responsible for lawful patient amounts, including applicable copayments, coinsurance, deductibles, and properly disclosed noncovered services. Contractual adjustments and amounts Cortina is prohibited from billing are not your responsibility.

Before receiving care, confirm that Cortina and your scheduled provider participate in your specific plan. Networks may vary among plans offered by the same insurance company.

Deductible estimates

If your plan indicates that your deductible has not been met, Cortina may collect an estimated amount at check-in. After your insurer processes the claim, that payment will be applied to your final patient responsibility.

Patients without insurance and patients using out-of-network benefits must pay in full at the time of service. Unless required by law or a payer agreement, Cortina does not submit claims for out-of-network benefits. It is your responsibility to confirm network participation before receiving care.

Cosmetic dermatology, clinical skincare, and elective laser or device services are self-pay and are not billed to insurance.

Independent pathology and laboratory services

Biopsies, cultures, and other tests may be analyzed by independent laboratories that are not owned or operated by Cortina. The laboratory may bill you separately. When the expected laboratory is reasonably known before service, Cortina will identify it so you can ask the laboratory and your insurer about network status and pricing. A Cortina estimate will indicate whether separately billed laboratory charges are included. An uninsured or self-pay patient may also request a separate estimate from the laboratory.

Payment is due at the time of service unless Cortina has approved another arrangement in advance. We accept cash, checks, Visa, Mastercard, American Express, and Discover.

If you separately authorize Cortina to store and charge a credit or debit card, Cortina may use that card for copayments, deductible estimates, outstanding patient balances, and applicable late cancellation or no-show fees. Any charge is subject to the terms of the card authorization you provide. A receipt is available upon request. Scheduling an appointment or acknowledging this policy alone does not authorize a card charge.

A returned-check handling charge of up to $30 may apply. Postdated checks are not accepted.

We reserve appointment time specifically for your care. Please cancel or reschedule at least 24 hours before the scheduled start time.

Late cancellation means cancellation or rescheduling with less than 24 hours’ notice. If an appointment fits the second category, the $150 fee applies. Except where prohibited by law or payer agreement, this fee schedule applies consistently by appointment category and the fees are not submitted to insurance. Where applicable, TennCare members are not charged late cancellation or no-show fees. Any card charge requires a separate card authorization.

If you arrive more than 15 minutes late, your appointment may need to be rescheduled. Three or more late cancellations or no-shows may prompt an individualized administrative and clinical review. An established patient relationship will be ended only with appropriate written notice and continuity-of-care arrangements.

After written notice and an opportunity to resolve the account, patient balances not paid within 60 days of the first billing statement may be referred to a licensed collection agency. Any collection cost, court cost, or attorney fee will be assessed only when expressly authorized by a valid signed agreement and permitted by law.

Venue and jurisdiction for any legal proceeding are determined by applicable law. If you begin an eligible federal patient-provider billing dispute, Cortina will suspend collection activity while the dispute is pending as required by law.

Please contact the clinic promptly if you have a question about a balance or need to discuss an arrangement. Any payment arrangement must be approved in advance.

Authorization and acknowledgment

Scheduling reserves appointment time. Before or at check-in, the patient or responsible party will be asked to review and affirmatively acknowledge the current policy. Policy acknowledgment alone is not a card authorization, assignment of benefits, or clinical consent.

When separately stated in documents you sign or electronically acknowledge, you:

• Authorize available insurance payments to be made directly to Cortina for eligible services rendered.
• Accept responsibility for lawful patient amounts assigned under your plan, including applicable copayments, coinsurance, deductibles, and properly disclosed noncovered services.
• Understand that independent laboratories or referred providers may issue separate charges governed by their billing policies, your health plan, and applicable law.
• Acknowledge that repeated unresolved balances or failure to follow an approved payment arrangement may prompt individualized review and, when appropriate, termination of the patient-provider relationship after written notice and transition arrangements.