Financial Policy
Effective Date: January 1, 2026
1. Overview
LoDo Pain, LLC operates as a self-pay specialty chronic pain clinic.
This Financial Policy explains payment expectations, billing procedures, and related administrative policies. By scheduling or receiving services, you agree to the terms outlined below.
2. Self-Pay Model
LoDo Pain operates on a direct-care, self-pay basis.
Clinical services are not billed to commercial insurance carriers.
We do not participate in-network with insurance plans.
Payment is due at or before the time of service unless otherwise specified in writing.
This model is not insurance and is not a prepaid health plan.
Payment of fees does not guarantee any specific treatment, medication, prescribing decision, or continuation of care.
Insurance may be used separately for prescriptions, laboratory services, imaging, or other third-party services not operated by LoDo Pain.
3. Medicare & Medicaid (AHCCCS)
LoDo Pain does not provide services to individuals enrolled in Medicaid, including the Arizona Health Care Cost Containment System (AHCCCS).
Certain LoDo Pain providers have formally opted out of Medicare and may enter into private contracts with Medicare beneficiaries in accordance with federal law.
If you are enrolled in Medicare and choose to receive services from an opted-out provider:
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Services will be provided under a written private contract as required by federal regulations.
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Neither the provider nor the patient may submit claims to Medicare for reimbursement.
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Medicare will not reimburse for services provided under the private contract.
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The patient agrees to be fully responsible for payment of all charges.
If you are enrolled in Medicare or Medicaid, you must notify our office prior to scheduling services.
4. Payment Terms
A valid payment method must be maintained on file.
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Fees may be collected at the time of scheduling or at the time of service.
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Failure to maintain a valid payment method may result in cancellation or rescheduling of appointments.
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Outstanding balances must be resolved prior to future scheduling.
5. Initial Evaluation / Administrative Setup
A one-time onboarding fee may be required to establish care.
This fee covers intake processing, record review coordination, and administrative setup.
The onboarding fee is non-refundable once administrative processing has begun.
6. Ongoing Care Access Plan
Certain patients requiring ongoing medication management may be enrolled in a Care Access Plan.
Care Access Plan fees:
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Are billed automatically on the 1st of each month
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May be prorated for the initial month
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Are non-refundable once the billing period has begun
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Provide scheduled follow-up access and administrative coordination
Enrollment in the Care Access Plan:
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Does not guarantee prescribing of any medication
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Does not guarantee continuation of any specific treatment
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Does not alter clinical decision-making
Written notice is required prior to the next billing cycle to discontinue enrollment.
7. AutoPay & Recurring Payments
Patients enrolled in AutoPay authorize recurring charges to the payment method on file for applicable Care Access Plan fees and authorized charges.
If a scheduled AutoPay transaction:
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Fails
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Is declined
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Is reversed
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Is disputed
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Or is otherwise not successfully processed
The AutoPay discount (if applicable) will be removed for that billing period, and the standard rate will apply.
The discounted rate resumes once AutoPay is restored and payments are current.
8. Nonpayment & Administrative Action
Failure to maintain current payment status may result in:
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Appointment cancellation
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Suspension of scheduling
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Administrative discharge from the practice, subject to clinical review and patient safety considerations
Administrative discharge for nonpayment does not obligate continuation of treatment beyond applicable legal or ethical requirements.
9. Refund Policy
Fees for:
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Completed appointments
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Onboarding/setup processing
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Care Access Plan billing periods
Are non-refundable once services have been rendered or the billing period has begun.
Refunds are issued only in cases of verified administrative error or duplicate billing.
Approved refunds are processed to the original payment method within 7–10 business days.
Where permitted by law, a processing adjustment of up to 3% may be deducted to offset non-recoverable merchant transaction fees.
10. Missed Appointments & Cancellations
Appointments must be canceled at least one (1) business day in advance.
Missed appointments or late cancellations may result in:
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A missed appointment fee
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Forfeiture of prepaid visit fees
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Rescheduling restrictions
Repeated missed appointments may result in administrative review of continued scheduling eligibility.
11. Third-Party Services
Pharmacy services, laboratory testing, imaging, and other ancillary services are not operated by LoDo Pain.
Patients are responsible for charges associated with third-party providers.
Coverage for such services is determined by the patient’s individual insurance plan.
12. Billing Inquiries
If you believe a billing error has occurred, you must notify us in writing via email at info@lodopain.com within 30 days of the charge.
We will review and respond promptly.
13. Important Notice
Payment of fees does not guarantee:
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Evaluation for controlled substances
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Prescription of any medication
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Dose escalation
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Continuation of therapy
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Enrollment eligibility in any structured care plan
All clinical decisions are made by licensed healthcare providers based on medical judgment, safety standards, and applicable law.