Financial Policy

1. Insurance Billing & Cost-Sharing Commitments

Kairos Sleep Clinic (operating legally as Kairos Health PLLC) participates with a variety of commercial insurance panels. As a courtesy, our billing team will submit claims to your insurance carrier on your behalf. However, you maintain ultimate financial responsibility for all services rendered.

• Copayments, Deductibles, and Co-insurance: All standard cost-sharing fees are due strictly at the time of service. If a digital card is stored on file, it may be automatically processed for these fees upon check-in. However, as we do not currently mandate or support storing cards on file for all patients, we also reserve the right to send you a statement or bill for any outstanding balances.
• Prior Authorizations: Certain sleep therapies and diagnostics (such as home sleep apnea testing or specialized pharmaceuticals) require insurance pre-authorization. While we advocate for your coverage, if your carrier ultimately denies authorization or coverage for a service, you are fully responsible for the self-pay rate of that service.

2. 24-Hour Cancellation and No-Show Fees

Your appointment time is reserved exclusively for your care. Because we operate an active virtual practice, late cancellations prevent other patients from accessing timely scheduling slots.

• If you need to cancel or reschedule your encounter, you must provide a minimum of 24 hours' advanced notice to the clinic.
• Failure to provide a 24-hour notice, or failing to attend a scheduled virtual visit, will result in an automated $50.00 No-Show Fee.
• Important Regulatory Note: No-show and late-cancellation fees cannot be billed to commercial health insurance, Medicare, or federal programs. This fee must be paid completely out-of-pocket prior to your next scheduled encounter.

3. Your Rights and Protections Against Surprise Medical Bills (No Surprises Act)

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing (surprise billing). In these cases, you shouldn't be charged more than your plan's copayments, coinsurance, and/or deductible.

As an outpatient sleep medicine clinic, we strive for complete transparency:

• You are protected from balance billing for services rendered directly by our providers if we are in-network with your primary carrier.
• If you are uninsured or choose to pay for services completely out-of-pocket (self-pay), federal law requires that we provide you with a comprehensive Good Faith Estimate (GFE) detailing the exact costs of your scheduled consultation, follow-ups, and prospective diagnostics before care is delivered.
• For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call the federal enforcement line at 1-800-985-3059.

4. Third-Party Referral Billing (Sleep Studies & Diagnostics)

In the course of your care, we may refer you to external, third-party organizations for diagnostic testing, equipment, or specialized clinical services (such as independent sleep testing laboratories, home sleep test distributors, or durable medical equipment providers).

• No Shared Liability: Kairos Sleep Clinic (Kairos Health PLLC) is not responsible, liable, or in any way involved in any billing, pricing, collection practices, or charges levied by these independent third parties.
• Patient Responsibility: It is the patient's sole responsibility to contact the referred third-party provider directly to verify their network status, benefit coverage, out-of-pocket costs, and specific billing procedures prior to receiving any referred services.