Financial Policy

(revised 1.13.25)

Thank you for choosing Sleep Centers of Middle Tennessee, PLLC (“SCMT”) for your sleep medicine care.

For insured patients, any specialist copays are due at the time of your clinic or telehealth appointment. For sleep testing, we may ask that you prepay a small portion of the estimated out of pocket at the time you schedule. We will bill your insurance for all services rendered. Your insurance company will send you an Explanation of Benefits (EOB) that explains how much they paid and how much you are ultimately responsible for. These are usually available 10 to 30 days after we bill for your visit. You will receive a statement notification from SCMT that reflects the after-insurance amount due, if any.

If you are not using medical insurance or do not have insurance for your office visits, we may ask that you pay your estimated out-of-pocket amount or make payment arrangements at the time of your appointment.

1. Payment Methods 

We accept cash, check, HSA/FSA, debit/credit cards, and Care Credit (which provides low or no interest payment plans for 6 to 24 months). Click here to apply for Care Credit. 

2. Credit Card on File 

We offer a convenient option for patients to securely store your credit card, debit card, or HSA card until your insurance(s) have fully processed your claim, paid their portion, and notified us of the exact balance due from you (if any). Balances owed may be automatically applied to the card on file. Patients receive advance email notification from SCMT 10 days and 2 days prior to the date of charge. SCMT will email you successful payment confirmation. This in no way compromises your ability to dispute a charge or question your insurance company’s EOB.

3. Estimated Out of Pocket Cost

SCMT may provide you with an estimated out of pocket cost (or EOOP). Your EOOP is not the exact amount that you may ultimately owe. It is only an estimate. SCMT’s charge amounts are consistent and determined by your insurance carrier, but the amount your insurance company pays will vary depending on your deductible, coinsurance and other factors. After your insurance processes your claim, you will receive notification of any amount due.

4. Payment Plan 

If you receive a statement and are unable to pay your bill in full, we offer flexible payment plans. Patients have complete control of the amount and frequency of payments. You can set up a payment plan online, in office or by calling our billing number at (615) 921-2400. 

Standard Terms

• Proof of insurance and photo ID are required for all patients so that we may make a copy for our records. Providing a copy of your insurance card does not confirm that your coverage is effective or that the services rendered will be covered by your insurance company. You may be asked to show your insurance card at each visit.
• It is your responsibility to know your insurance benefits, including whether we are in network and whether sleep medicine is a benefit covered by your policy. SCMT is not responsible to inform you prior to your visit if we are out of network, our services are excluded from your policy, or if your policy offers limited annual benefits. If your insurance declines to pay, you will be responsible for all services rendered out of pocket. Contact your insurance company with any questions about your plan and benefits.
• It is your responsibility to provide current and accurate insurance information. Should you fail to provide this information, you will be financially responsible for any amounts your insurance declines to pay. If your insurance plan or policy changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.
• Balances over 90 days old will be referred to collections.

No Show/Late Cancellation Policy

Advance notification of at least one business day is required to cancel or reschedule an appointment. Missing a Clinic or Telehealth appointment without notification may result in a $50 fee. Missing an In-Lab Sleep Testing appointment without notification may result in a $100 fee.

RING Usage/Return Policy
Additional charge of $300 “No Return Fee” for Sleep Image RING home sleep testing device may apply if the RING device is not returned to SCMT within 10 calendar days after it is received by patient. If the device is returned in an unusable condition due to patient negligence or damage which occurred while the device was in the patient’s possession, the same fee will apply. 

A $75 “No Use Fee” shall automatically be charged if the device is sent or delivered to patient but is returned to SCMT without a test performed.

Returned Check 

A $30 fee will be charged if a check is returned by patient’s financial institution. 

I have read the financial policies above, and my signature below serves as acknowledgement of a clear understanding of my financial responsibility. I authorize my insurance benefits to be paid directly to Sleep Centers of Middle Tennessee, PLLC. I understand that if my insurance company denies coverage and/or payment for services provided to me or my dependents, I assume financial responsibility and will pay all such charges in full. 

I understand that once my insurance has paid their portion for the medical care received from SCMT, the remaining balance is my responsibility as shown on my Explanation of Benefits (EOB) from my insurance company.

Thank you for choosing Sleep Centers of Middle Tennessee, PLLC (“SCMT”) for your sleep medicine care.

For insured patients, any specialist copays are due at the time of your clinic or telehealth appointment. For sleep testing, we may ask that you prepay a small portion of the estimated out of pocket at the time you schedule. We will bill your insurance for all services rendered. Your insurance company will send you an Explanation of Benefits (EOB) that explains how much they paid and how much you are ultimately responsible for. These are usually available 10 to 30 days after we bill for your visit. You will receive a statement notification from SCMT that reflects the after-insurance amount due, if any.

If you are using medical insurance or do not have insurance for your office visits, we may ask that you pay your estimated out-of-pocket amount or make payment arrangements at the time of your appointment.

1. Payment Methods 

We accept cash, check, HSA/FSA, debit/credit cards, and Care Credit (which provides low or no interest payment plans for 6 to 24 months). Click here to apply for Care Credit. 

2. Credit Card on File 

We offer a convenient option for patients to securely store your credit card, debit card, or HSA card until your insurance(s) have fully processed your claim, paid their portion, and notified us of the exact balance due from you (if any). Balances owed may be automatically applied to the card on file. Patients receive advance email notification from SCMT 10 days and 2 days prior to the date of charge. SCMT will email you successful payment confirmation. This in no way compromises your ability to dispute a charge or question your insurance company’s EOB.

3. *Estimated Out of Pocket Cost

SCMT may provide you with an estimated out of pocket cost (or EOOP). Your EOOP is not the exact amount that you may ultimately owe. It is only an estimate. SCMT’s charge amounts are consistent and determined by your insurance carrier, but the amount your insurance company pays will vary depending on your deductible, coinsurance and other factors. After your insurance processes your claim, you will receive notification of any amount due.

4. Payment Plan

If you receive a statement and are unable to pay your bill in full, we offer flexible payment plans. Patients have complete control of the amount and frequency of payments. You can set up a payment plan online, in office or by calling our billing number at (615) 921-2400. 

Standard Terms

• Proof of insurance and photo ID are required for all patients so that we may make a copy for our records. Providing a copy of your insurance card does not confirm that your coverage is effective or that the services rendered will be covered by your insurance company. You may be asked to show your insurance card at each visit.
• It is your responsibility to know your insurance benefits, including whether we are in network and whether sleep medicine is a benefit covered by your policy. SCMT is not responsible to inform you prior to your visit if we are out of network, our services are excluded from your policy, or if your policy offers limited annual benefits. If your insurance declines to pay, you will be responsible for all services rendered out of pocket. Contact your insurance company with any questions about your plan and benefits.
• It is your responsibility to provide current and accurate insurance information. Should you fail to provide this information, you will be financially responsible for any amounts your insurance declines to pay. If your insurance plan or policy changes, please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits.
• Balances over 90 days old will be referred to collections.

No Show/Late Cancellation Policy

Advance notification of at least one business day is required to cancel or reschedule an appointment. Missing a Clinic or Telehealth appointment without notification may result in a $50 fee. Missing an In-Lab Sleep Testing appointment without notification may result in a $100 fee.

RING (Home Sleep Test) Usage/Return Policy

Additional charge of $300 “No Return Fee” for Sleep Image RING home sleep testing device may apply if the RING device is not returned to SCMT within 10 calendar days after it is received by patient. If the device is returned in an unusable condition due to patient negligence or damage which occurred while the device was in the patient’s possession, the same fee will apply.

A $75 “No Use Fee” shall automatically be charged if the device is sent or delivered to patient but is returned to SCMT without a test performed.

Returned Check Policy

A $30 fee will be charged if a check is returned by patient’s financial institution.

I have read the financial policies above, and my signature below serves as acknowledgement of a clear understanding of my financial responsibility. I authorize my insurance benefits to be paid directly to Sleep Centers of Middle Tennessee, PLLC. I understand that if my insurance company denies coverage and/or payment for services provided to me or my dependents, I assume financial responsibility and will pay all such charges in full. 

I understand that once my insurance has paid their portion for the medical care received from SCMT, the remaining balance is my responsibility as shown on my Explanation of Benefits (EOB) from my insurance company.