Patient Rights & Responsibilities

Body Image Physical Therapy and Fitness believes all of our patients have certain rights and responsibilities: Access to Respectful Care You have the right to considerate, responsible and respectful care that recognizes and maintains your dignity and values regardless of race, gender, age, religious beliefs, national origin, sexual orientation, disability or source of payment. You can expect to receive care in a clean and safe environment. Privacy and Confidentiality Your need for privacy will be honored. You can expect that any discussion or consultation involving your care will be conducted discreetly. Individuals not directly involved in your care will not have access to information about you. Your medical records will not be released without your authorization, except as required by law. Informed Consent You can expect to receive the medical information you need to participate in your health care decisions. This information includes assessment, risks and benefits of treatment, serious side effects, alternatives to treatment, and consequences of no treatment. You are free to withdraw consent and discontinue treatment. You are entitled to this informed consent prior to the start of your care. Staff Identification You can expect to know the names and professional status of the therapists, assistants, aides, and office staff who are providing care to you. Consultation You have a right to request a consultation with another therapist when you are making a treatment decision for yourself. Access to Records You may review your medical record at any time. Others not involved in your care must have a written release to look at your medical record. Billing You are entitled to a complete explanation and itemization of your bill. All billing questions should be directed to MBC billing at 866-679-1600 ext. 324 (Tina is our billing specialist). Providing Information As a patient, you will need to contribute to your treatment planning by providing us with information that is accurate and complete, to the best of your knowledge, about present complaints, current medical conditions, past illnesses, injuries, and surgeries, medications, other treatments you are receiving, and any other matters relating to your health. Please report unexpected changes in your condition to your therapist or other clinical staff for adjustments in your treatment. Understanding Information As a patient, it is important to fully understand your plan of care and to be able to follow the recommendation of your therapist. You are invited, at any time, to seek clarification of your treatment plan. Consideration of Others (Cancellation & No-Show Policy) Please notify the clinic as soon as you discover that you will be unable to attend a scheduled appointment. Kindly give at least 24 hours notice for cancellations so that other patients have an opportunity to attend an appointment during that time. If you do not give proper notice, you will be charged $30 per missed appointment beginning with the 1st missed appointment. If you repeatedly miss appointments, we will limit the times that you can schedule. Eventually, we will have to discharge you. Of course, emergency situations arise, and weather issues, which would not fall under this policy. Financial Obligations You are responsible for knowing the extent and limitations of your health care benefits as contained in your insurance policy. Your policy is between you and your insurance carrier, not between Body Image and your insurance carrier. You are ultimately responsible for your bill. You are responsible for assuring that the financial obligations for your health care are fulfilled. The front office and billing staff will assist you in these matters whenever possible. In cases where the insurance company pays you directly instead of the clinic, you are to sign over and forward the check and explanation of benefits to the clinic, so that billing can properly apply any payments and adjustments to your account. Non-adherence to this policy may result in loss of any discount that might have applied.