Cancellation and Refund Policy

3. Definitions

• Covered appointment: an infusion or other treatment scheduled to be physically performed at the Klearmind clinic.
• Late cancellation: cancellation of a covered appointment received less than 24 hours before its scheduled start time.
• No-show: the patient has neither arrived nor contacted the clinic within 30 minutes after the scheduled start time.
• Valid notice: notice provided by telephone, voicemail, or CharmHealth portal message. The recorded timestamp controls.
• Charged occurrence: an event for which the clinic assesses the $100 fee under this policy after applying any exception or program restriction.

4. Card on file and authorization

Before a covered appointment, Klearmind requires a valid payment card on file and the patient’s or cardholder’s signed authorization to charge fees permitted by this policy. Payment-card information must be maintained only within the clinic’s approved payment-processing system. The clinic will not record a full card number in this policy form or in free-text clinical documentation.

5. Cancellation notice

Patients must provide at least 24 hours’ notice to cancel or reschedule a covered appointment. Notice may be provided by telephone, voicemail, or CharmHealth portal message. Email and ordinary text messaging are not accepted cancellation methods under this policy.

6. Standard $100 fee

A $100 fee may be charged for any of the following:

• A cancellation received less than 24 hours before a covered appointment, unless the patient immediately reschedules through the same call, message exchange, or direct follow-up and the clinic accepts the new appointment.
• A no-show.
• Arrival more than 30 minutes after the scheduled start time when the clinic cannot safely or operationally complete the treatment.
• Failure to follow communicated pre-treatment or transportation requirements when the treatment cannot safely proceed.

Late-arrival accommodation: if the patient arrives more than 30 minutes late and the clinic can safely accommodate the treatment, no late-arrival fee will be charged.

7. Medical-safety and discretionary exceptions

No fee will be charged when a Klearmind clinician cancels or postpones treatment for a medical-safety reason, including acute illness or abnormal vital signs. Klearmind may waive a fee for exceptional circumstances at the clinic’s discretion. The clinic need not publicly enumerate every circumstance and will document the determination in the appropriate administrative record.

8. Charging, receipt, and outstanding balance

An authorized fee may be charged on the date of the occurrence. A receipt or notice of the charge will be sent through CharmHealth. An outstanding cancellation, late-arrival, or no-show fee must be paid before another covered on-site treatment is scheduled, unless a clinic-approved exception applies.

9. Prepaid sessions

When the patient has prepaid for a package or individual session, only the $100 fee is assessed for a charged occurrence. The treatment session itself is not forfeited. Prepaid sessions and account credits are restricted to the original patient and are not transferable to another person.

10. Package cancellation and refunds

• Unused prepaid sessions are refundable.
• If a package has been partially used, each completed infusion will be repriced at the regular single-infusion rate of $550. The value of completed infusions will be subtracted from the amount paid, and the remaining balance will be refunded.
• Example: for a $3,100 package with two completed infusions, $1,100 is deducted and the remaining $2,000 is refunded.
• Klearmind will initiate an approved refund within seven business days and return it to the original payment method when possible.

11. Unused prepaid credits

Unused prepaid funds do not expire and remain available indefinitely as a dollar credit for the original patient. When treatment resumes, the dollar credit is applied to the prices then in effect rather than to the original package or session price. Clinical eligibility may require reassessment before treatment resumes.

12. Repeated charged occurrences

• First charged occurrence within a rolling 12-month period: the $100 fee and a written warning through CharmHealth.
• Second charged occurrence within the same rolling 12-month period: the $100 fee and, after physician review and written notice, Klearmind may discontinue scheduling elective on-site treatment.
• A patient whose elective on-site scheduling has been discontinued under this section may request reevaluation after 12 months.

Discontinuing elective on-site scheduling under this policy does not automatically terminate the physician-patient relationship. Any broader termination of care must follow a separate continuity-of-care and patient-notice process.

13. Government program and payer limitations

This policy applies only where permitted by applicable law and the governing payer, referral, or program agreement.

• VA-authorized care: Klearmind will not charge the veteran directly for a covered appointment associated with authorized VA Community Care unless written program or payer authorization expressly permits the charge.
• Medicare: a missed-appointment fee will not be billed to Medicare. If applied to a Medicare beneficiary, it must be charged directly to the patient only when permitted and applied consistently to Medicare and non-Medicare patients under the same clinic policy.
• Medi-Cal and other programs: staff must verify applicable restrictions before charging. No fee will be assessed when prohibited by law, contract, program rule, or payer requirement.

References and related documents

• Centers for Medicare & Medicaid Services, MLN Matters MM5613, Charges for Missed Appointments.
• California Department of Health Care Services, The Facts on Balance Billing, and applicable Medi-Cal program guidance.
• U.S. Department of Veterans Affairs, Community Care billing and authorized-care requirements.
• Medical Board of California guidance concerning termination of the physician-patient relationship and continuity of care.
• Klearmind Pricing and Payment Policy; Patient Financial Responsibility and Card-on-File Authorization; and applicable treatment-specific instructions.