Last Updated: 1/1/2024

FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY

This website is owned and operated by This Is Not What I Signed Up For, LLC (“Company,” “we,” or “us”). This Disclaimer, together with the Terms & Conditions of Use and Privacy Policy, governs your access to and use of thisisnotwhatisignedupfor.org including any content, functionality, products, and services offered on or through thisisnotwhatisignedupfor.org (the “Website”), whether as a guest or a registered user.

Please read the Disclaimer carefully before you start to use the Website. By using the Website or by clicking to accept or agree to the Terms & Conditions of Use when this option is made available to you, you accept and agree to be bound and abide by the Disclaimer. If you do not want to agree to the Disclaimer, you must not access or use the Website.

Beginning in January of 2024 our office will begin taking healthcare insurance.

This is not a guarantee of service or coverage. Not all insurance providers will be accepted. What is and is not available is largely out of our control.

PATIENT HEALTH INSURANCE WAIVER

All individuals requesting sessions with our office will be required to sign the below:

"I have requested services and/or therapies provided by acupuncturist Gianina G. Knoth, Ph.D., L.Ac. of This Is Not What I Signed Up for LLC.                             

I understand that these services and/or therapies may be billed to my insurance company on my behalf.

I am electing to self-pay for my treatment, and I am requesting that no claim be sent to my insurance.  It is my personal decision not to use my health insurance benefits even though I understand that these services are considered covered by my policy. (Elective Self Pay).  

I understand that by choosing elective self-pay, I cannot, in the future, request that the provider stated above, go back and retroactively bill my insurance and give me a refund for those dates that I’ve already paid for with the chosen elective self-pay.  

I also understand that since I have requested elective self-pay, I cannot, in the future, submit claims for this provider on my own and be reimbursed by the insurance company.  I understand the provider is in-network, and therefore is under contract to submit the claims on my behalf if I choose to submit them to my insurance company." 

Nothing above includes a contract, a promise of treatment, acceptance of coverage, or a guarantee of benefits. You I responsible for communicating with your healthcare provider and educating yourself about your healthcare benefits.

HEALTHCARE INSURANCE AGREEMENT AND FINANCIAL POLICY

Should you choose to book an appointment, you will be required to sign the below:

"Thank you for choosing us as your healthcare provider. We are committed to your treatment being successful. Please understand that payment of your bill is considered part of your treatment. The following is a statement of our Financial Policy, which we require you to read and sign prior to any treatment. 

Special financial arrangements and payment plans are not available.

Provider’s fees are determined by the complexity of the particular case and services used during your treatment. 

OUR MAIN CONCERN IS YOUR HEALTH AND WELL BEING AND WE WILL DO OUR BEST TO HELP YOU.

The self-pay plan means that all fees will be paid when the service is rendered.  

If you have insurance, we will bill your provider for you as a courtesy.  Payment for your deductible, if it has not been met, is the responsibility of the patient, as well as any copayment, or remaining balance after insurance payment has been made.  

We accept CASH, CHECKS, MASTERCARD, VISA, AMERICAN EXPRESS, DISCOVER, and HEALTH CARE SAVINGS CARDS for all or partial payment. We currently accept Venmo, PayPal, Apple Pay, Zelle, and Cash App. Accepted payment methods are subject to change at any time.

If care is discontinued, the balance for care received up to that date is due in full in 30 days.

I understand that all responsibility for payment of services provided in this office for myself or my dependents is mine, due and payable at the time services are rendered unless other arrangements have been made.  I permit this office to endorse co-issued remittances for the conveyances of credit to my account.  

When getting eligibility and benefit information from your insurance company, we are sometimes given incorrect information. We pass on to you the information we are given by your insurance, but we make no guarantees that this information is correct.  Each insurance company recites a disclaimer when giving eligibility and benefits to excuse them from any misinformation given or any changes that may occur in your plan since the benefits inquiry. We do the best we can to assist you, but please understand it is ultimately your responsibility to know the benefits of your insurance plan.  

Missed Appointments 

Unless canceled at least 24 hours in advance, our policy is to charge for missed appointments at the rate of a normal office visit. Your treatments will be more effective if you follow your provider’s guidelines and stick to your treatment schedule. Please help us to serve you better by keeping scheduled appointments. 

Please sign below to indicate your understanding of our financial policies.  I have read the Financial Policy and the Missed Appointments Policy.  I understand and agree to the Financial Policy and the Missed Appointments policy.  A photocopy of this form shall be considered as effective as the original."

I understand and agree that if I fail to make any of the payments for which I am responsible in a timely manner, I will be responsible for all costs of collecting monies owed, including court costs, collection agency fees, and attorney fees.

I authorize the Provider to release any medical or other information that may be necessary to process medical claims on my behalf to related physicians, rehabilitation counselors, social workers, insurance carriers, billing staff, or attorneys.  

Charges related to Worker's Compensation injury shall be forwarded to the Worker's Compensation Insurance carrier and I will not be held personally responsible for these charges.  However, be advised if you claim W/C benefits and are subsequently denied such benefits, you may be held responsible for the total amount of charges for services rendered to you.

I understand that I am responsible for paying my co-payments, co-insurance, and deductibles at the time of service.  I also understand that I am responsible for any balance due after payment by my insurance company.  

If my insurance carrier makes payments to me, I agree to immediately pay over 100% of these funds to the Provider.  I also authorize the Provider to deposit the check received on my account when made out to me. The amount due Provider is inclusive of the amount the insurance company pays me, as well as any deductible or copayment portion which may also be due.  If I do not, I agree to be billed for and pay the full amount of the bill as indicated under the patient responsibility explanation from my insurance company.

I AUTHORIZE THIS OFFICE TO RELEASE ANY INFORMATION NECESSARY TO ADJUDICATE THIS CLAIM.

Benefits that we have received from your insurance carrier at the time of service are not a guarantee of benefits.  The patient, legal guardian, or parent (if the patient is under 18 years old) will be responsible for the co-payment, coinsurance, and my deductible at the time of service.  

Regarding Insurance and ASSIGNMENT OF BENEFITS

In signing this document, I hereby request that my insurance carrier make payment directly to Gianina Knoth/ This Is Not What I Signed Up For, LLC for all services rendered by this facility.  If my current policy prohibits direct payment to the Provider, I hereby instruct and direct my insurance carrier to make the check out in my name but send the check to the Provider.

I, the undersigned, understand that the Provider will bill my insurance carrier for services rendered upon verification of coverage by my insurance company.  I understand that verification of benefits is not a guarantee of payment and my financial responsibility is subject to change.  If my insurance company fails to render payment for services rendered, I hereby personally guarantee payment for medical care and services rendered.  If my insurance company does not remit payment within 60 days, I understand that I will be responsible for the balance due in full."

All of the above within quotations will be required to be initialed and signed by all patients willing and able to use healthcare insurance coverage for their sessions.

Nothing above includes a contract, a promise of treatment, acceptance of coverage, or a guarantee of benefits. You I responsible for communicating with your healthcare provider and educating yourself about your healthcare benefits.

SITE ACCESS 

By accessing this site, I (herein referred to as “Visitor,” understand and acknowledge that it is for informational purposes only. Visitor understands this Website will not prescribe or assess health, provide health care, medical or nutrition therapy services; or diagnose, treat or cure any disease, condition or other physical or mental ailment of the human body.

Visitor understands if they should experience any medical issues, including mental health crises, they should see a medical doctor or call 911 immediately.

Visitor understands that accessing or using this site in any capacity is not to be construed as medical or nursing advice and is not meant to take the place of exam and evaluation from licensed health professionals.

NOT PROFESSIONAL ADVICE

The information contained on this Website and in the Resources is not intended as, and shall not be understood or construed as, professional advice. While the contributors, employees and/or owners of the Company are professionals and the information provided on this Website relates to issues within the Company’s area of professionalism, the information contained on this Website is not a substitute for advice from a professional who is aware of the facts and circumstances of your individual situation.

We have done our best to ensure that the information provided on this Website and the resources available for download are accurate and provide valuable information. Regardless of anything to the contrary, nothing available on or through this Website should be understood as a recommendation that you should not consult with a professional to address your particular situation. The Company expressly recommends that you seek advice from a professional.

Neither the Company nor any of its employees or owners shall be held liable or responsible for any errors or omissions on this Website or for any damage you may suffer as a result of failing to seek competent advice from a professional who is familiar with your situation.

NO PROFESSIONAL-CLIENT RELATIONSHIP

Your use of this Website, including implementation of any suggestions set out in this Website and/or use of any of the Resources, does not create a professional-client relationship between you and the Company or any of its professionals.

You recognize and agree that we have not created any professional-client relationship by the use of this Website.

USER’S PERSONAL RESPONSIBILITY

By using this Website, you accept personal responsibility for the results of your actions. You agree to take full responsibility for any harm or damage you suffer as a result of the use, or non-use, of the information available on this Website and in the Resources. You agree to use judgment and conduct due diligence before taking any action or implementing any plan or policy suggested or recommended on this Website or in the Resources.

NO GUARANTEES

You agree that the Company has not made any guarantees about the results of taking any action, whether recommended on this Website or not. 

You also recognize that prior results do not guarantee a similar outcome.  Thus, the results obtained by others, whether clients or customers of the Company or otherwise, applying the principles set out in this Website are no guarantee that you or any other person or entity will be able to obtain similar results.

ERRORS AND OMISSIONS

This Website is a public resource of general information that is intended, but not promised or guaranteed, to be correct, complete, and up to date.  We have taken reasonable steps to ensure that the information contained in this Website is accurate, but we cannot represent that this Website is free of errors. You accept that the information contained on this Website may be erroneous and agree to conduct due diligence to verify any information obtained from this Website and/or the Resources before taking any action.  You expressly agree not to rely upon any information contained in this Website or the Resources.

NO ENDORSEMENTS

From time to time, the Company will refer to other products, services, coaches, consultants, and/or experts. Any such reference is not intended as an endorsement or statement that the information provided by the other party is accurate. The Company provides this information as a reference for users. It is your responsibility to conduct your own investigation and make your own determination about any such product, service, coach, consultant, and/or expert.

CONTACT US

We welcome your questions or comments regarding the Disclaimer:

Email us: gg@thisisnotwhatisignedupfor.org

Call us: 954-796-0005

Write to us: 953 N University Drive, Coral Springs, FL 33071, United States