My Insurance Information
Covering the Cost of Treatment
THIS SECTION TAKES ABOUT 4 MINUTES TO
READ AND COMPLETE
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IMPORTANT INFORMATION ON THE
PATIENT INSURANCE BILLING PROCESS
YOUR INSURANCE: At the end of each month, your credit card will be processed to pay for the month's treatments. We will then immediately send you a professional receipt for your insurance submission. Once submitted, insurers usually take 48 hours max. to refund client. A credit card deposit may be required before you begin your treatment for the first month,.
MONTHLY MEMBERSHIPS: Must be covered at the beginning of the month before treatments can be extended. Remember that memberships require a 12 month commitment and must be approved by the doctor, based upon your medical condition and treatment requirements. We ask that you review all of the conditions of your membership before signing the contract.
CASH PAYMENTS: Cash can be collected at the clinic but we cannot provide change as our billing / administrative office is off-site. Please bring the exact amount of your payment. Receipts are provided at the end of each month only. BCD Pain Therapy Practitioners do not handle payments.
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Pile of Coins
C A S H
I wish to receive my receipts by:

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Credit Card
C R E D I T   C A R D
Credit Card is processed at end of each month. Information provided held by BCD Administration Centre. Your card will NOT be processed today.
What type of credit card

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MY INSURANCE INFO

How much $ per year does the insurer cover for 'chiropractic'?

Is there a deductible? (for example, they cover only 80% of the fee)

Upload Picture of Insurance Card

If possible, please take a picture of both sides of your insurance card and text/e-mail it to Better Call Doc so that Dr. Rice can keep it in your medical file.  437-983-PAIN (7246)

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