Financial and Cancellation Policy

Koger Cosmetic Clinic & Medspa Financial and Cancellation Policy

We understand that a situation could arise which would require you to postpone your surgery. However, please understand that a cancellation/postponement affects many individuals including healthcare professionals as well as patients. The surgical facility, anesthesiologist, surgeon and other staff are reserved and prescheduled in advance. When a surgery is scheduled, significant amount of time, effort and staffing is required to prepare for your surgery. Therefore, we ask that as soon as you become aware of the need to cancel/postpone your surgery, you notify our office as soon as possible. We value our relationship with you and its ongoing success through a mutual understanding of our financial and cancellation policies.

By signing at the bottom, you are acknowledging that you have read the policy and fully understand it.

1. To schedule your procedure and secure a surgery date, a non-refundable $500 deposit is required at the time of booking.


2. The remaining balance of the “Surgical fee” as well as any applicable implants, devices or garments are due 14 days prior to your surgery date. If your surgery is scheduled within 14 days of your surgery date, payment is due in full at the time of booking and all penalties apply.


3. If you decide for any reason to cancel your surgery, you will forfeit a $500 cancellation fee.
   If for any reason you cancel your surgery within 14 calendar days of your surgery date, you will forfeit fifty percent of the “Surgeons Fees”.
   If you decide for any reason to cancel your surgery within 3 business days of your surgery date, you will forfeit one hundred percent of the “Surgeons Fees”.


4. If you need to reschedule your surgery, it is important to notify us immediately to avoid penalty. Surgeries rescheduled within 14 calendar days of the surgery date will incur a $500 rescheduling fee. If we are notified more than 14 calendar days from your surgery date, a one-time courtesy will be given without penalty. Any additional rescheduling will incur a $500 rescheduling fee.
   Your surgery must be rescheduled to a date within 6 months of the original date. All pre-paid deposits are forfeited if not rescheduled within 6 months of the original surgery date. The balance still remains due in full 14 days prior to the original surgery date. 


5. All forfeited fees are non-transferable to another service, date or person.


6. Koger Cosmetic Clinic & Medspa does not employ the anesthesia provider, nor the providers of services rendered to you at hospitals and outpatient facilities. The anesthesia and hospital/outpatient center are independent entities, each exercising independent medical/nursing/health related practices and judgment and each bill separately for their services.


7. Operating Room and Anesthesia fees are paid directly to the surgical facility and anesthesia company are due prior to your surgery. These fees are charged on an hourly basis and are based on an estimated length of time. If the procedure(s) takes longer than anticipated, there will be additional charges for the additional time due and will be paid directly to the surgical facility or anesthesia company.


8. Not included in surgical fee for cosmetic procedure and/or self pay procedures: laboratory fees, radiology fees, necessary pathology, additional garments prescriptions, or other testing such as EKGs or chest X-rays. Dr. Koger sends all excised breast tissue for pathology. Pathology bills are the sole responsibility of the patient.
   
   
   
   1. Additionally, please note that should a hospital admission or additional surgery(ies) be necessary following your initial surgery due to a complication or unrelated event, the initial surgical fee will not cover those costs. Many insurance companies will not cover hospital or medical expenses for complications related with cosmetic surgery.
   
   
   
   


9. It has been our experience that the majority of cosmetic procedures are not covered by insurance plans. However, benefits paid by insurance companies vary; therefore, you should check with your carrier regarding coverage for cosmetic surgery prior to scheduling your procedure. Please note: We will NOT submit any claims for a cosmetic and/or self pay procedure on your behalf to Medicare or any insurance carrier and by signing below you acknowledge that your procedure is cosmetic in nature and not covered by your health insurance.


10. If a refund check is due to the patient for any reason, we require a minimum of 14 business days to process a refund check.


11. If you are FINANCING your surgery and a refund is due to the patient for any reason, we will refund you the amount the financing company paid to us, (which is the amount we collected minus financing fees). These fee percentages vary depending on the financing plan or card used.


12. Accepted forms of payment are cash, check, money order, cashiers check, Visa, Master Card, American Express, Discover and Care Credit Financing.


13. A $35.00 service charge will be applied to your account for all returned checks or any stopped payment issued on a check.


14. The practice of medicine and surgery is not an exact science. Although good results are anticipated, there can be no guarantee or warranty, expressed or implied, by anyone as to your results. Surgical revisions and/or other medical treatment or management of problems and/or complications may be required. These may result in additional surgeon’s fees, operating room fees, anesthesia fees and other associated fees.

I have read this two page document, have had the opportunity to ask questions, and clearly understand the financial policy of Koger Cosmetic Clinic & Medspa regarding my scheduled cosmetic surgery, and the independent nature of the healthcare professionals involved.