Appointment Arrival Policy

In order to give you and all of our patients the best possible care, we request that you complete your health history via our online portal prior to your scheduled appointment.  Our office will provide you with the link and the the instructions to do this.  Please contact our office if you have any problems accessing this link or completing your paperwork.  We ask that you arrive 10 minutes early for your appointment as there may be signatures or additional paperwork needed.  Arriving early will help keep your appointment from being shortened. We cannot extend your assigned treatment time in consideration for our other guests.

Cancellation and Missed Appointment Policy

We request that you review our policy regarding missed and/or cancelled appointments.  Our office realizes that there are many things that come up in people’s day to day lives.  While truly sympathetic, we have designated time and personnel for your individual treatment. Consequently, there will be a charge for any missed appointment times.  We consider an appointment “missed” if you fail to show up for a scheduled service without a phone call or without cancellation notice at least 24-hours prior to your appointment. If you fail to give us sufficient notice of your cancellation, the following policy will be applied:

  • VEIN CONSULT / SCLEROTHERAPY TREATMENT / ULTRASOUND APPOINTMENT
    Please call our office at least 24-hours in advance in order to avoid a missed appointment or late cancellation charge. There is a $25.00 missed appointment fee. For appointments allotted more than 1 hour, the fee will be $25.00 per hour of scheduled appointment.
  • SCHEDULED SURGERY
    We will call and offer to reschedule your surgery.  You will be charged a missed appointment fee of $100. 
  • SKIN CONSULT / AESTHETIC TREATMENT
    Please call our office at least 24-hours in advance in order to avoid a missed appointment or late cancellation charge. There is a $25.00 missed appointment fee. For appointments allotted more than 1 hour, the fee will be $25.00 per hour of scheduled appointment.
  • COOLSCULPT APPOINTMENT
    We are collecting a $250.00 deposit to reserve your appointment. Please call our office at least 24-hours in advance in order to avoid a missed appointment or late cancellation charge. There is a $25.00 missed appointment fee for 1 hour appointments. For appointments allotted more than 1 hour, the fee will be $25.00 per hour of scheduled appointment.

Cellular Phone Policy

In order for us to provide the best possible service, we kindly ask that you not use your cell phone during consultations and procedures.

Compression Hose Policy

Your upcoming vascular services require that you wear compression hose. Most insurance companies will not cover this purchase. It is our office policy to collect the fee at the time of purchase. If you would like to submit your receipt to your insurance company, we will be happy to supply you with the necessary paperwork. If you would prefer to purchase your hose at the pharmacy, our office will provide you with a written prescription. All compression hose sales are final.

Elective Procedure Policy

Wisconsin Vein Center & MediSpa is proud to offer the most beneficial state-of-the-art procedures available for veins, skin, and body. We strive to achieve a level of excellence which is unequalled by other centers, and we hope that you will notice this in our care.

All procedures performed in this office are elective.

It is your decision whether you wish to proceed with any recommended treatment. Therefore, it is the policy of this office, that any payment for services is due at the time of the procedure. If you are unable to pay in full, then treatment will be postponed until you can pay. We will assist you, if needed, to apply for financing through CareCredit.

Gift Card Policy

Guidelines for use of regular and holiday gift cards can be seen here.

Gratuity Policy

We are a professional medical office, so although we appreciate the thought, we cannot accept tips.

Medical Records Policy

Original records are the property of Wisconsin Vein Center & MediSpa and will not be released. Per federal regulations, we require a signed Medical Records Release Form prior to processing of duplicate copies of your records. If you would like to obtain a copy of your records FROM Wisconsin Vein Center & MediSpa, click here. If you would like your medical records sent from another facility TO Wisconsin Vein Center & MediSpa, click here.

Marketing & Appointment Reminders Policy

Our practice notifies patients of upcoming appointments, specials, and opportunities via emails, text messages, and phone calls.

Medicare/Medigap Authorization (For Medicare Beneficiaries)

Payments of the authorized Medicare Benefits will be made on your behalf to Deborah L. Manjoney, MD for any services furnished by this provider or organization.  By signing, you authorize any holder of medical information about you to be released to the Health Care Financing Administration and its agents any information needed to determine these benefits  or the benefits payable for related services. This authorization is in effect until you choose to revoke it in writing.

No Children Policy

We love children… however, so we may provide a safe and comfortable spa experience to all of our guests, children are not allowed at Wisconsin Vein Center & MediSpa.

Patient Identification Policy

To protect our patients and prevent the intentional or inadvertent misuse of patient names, identities and medical records, we will request documentation of every patient’s identity, address and insurance coverage at the time of registration.

Patient Privacy Policy

Our practice will maintain the confidentiality of patient medical and financial information as required by law. Click here to see our HIPAA policy. The full written HIPAA statement can also be viewed in the office at any time. To read the HIPAA Compliance Rules effective September, 2013, click here.  Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) patients have certain rights to privacy regarding protected health information. In the general course of your treatment, your information may be used to:

  • Conduct, plan and direct your treatment and follow-up among healthcare providers who may be involved in that treatment directly or indirectly
  • Obtain payment from third-party payers
  • Conduct normal healthcare operations such as quality assessments and physicians certifications
  • Carry out normal healthcare operations such as appointment reminders, treatment alternatives and health related services conducted either by mail or phone
  • When appropriate, use and disclose a patients information for statistical research
  • When required to do so, disclose health information when requested by international, federal, state or local law or to avert a serious threat to health or safety

Patients have the right to inspect and obtain copies of their medical record and request an accounting of disclosures. This organization reserves the right to change its Notice of Privacy Practices at anytime. If you would like to review a current copy of our policy, please contact the office.  Also feel free to contact the Privacy Officer should you have any questions regarding the handling of your confidential information.

Photograph Policy

Photographs will be taken as part of your treatment and will be kept in your medical record for education and/or marketing purposes. Complete confidentiality regarding photographs will be maintained by our office.

Price Quote Policy

All quoted prices are good for 30 days from the date of consultation.

Return Policy

All return of products must be completed within 30 days of purchase for an in-store credit only. All hosiery and make-up sales final. Service refunds are not available.

Treatment and Billing of Services Policy

Understand that you are authorizing and consenting to the performance of examinations, diagnostic procedures, and treatments which you and your attending physician/clinician agree are necessary. This consent shall remain in effect until you choose to revoke it in writing. By accepting treatment, you authorize the physician/clinician to release any information acquired in the course of your examination and/or treatment to specified physicians and/ or your insurance company.  Payments of services rendered are to be dispersed directly to Deborah L.  Manjoney, MD.  You are financially responsible for all deductibles, copayments and coinsurance amounts along with any amounts for non-covered and not medically necessary services.  All patient portions to include applicable deductibles, copayments, coinsurance and non-covered services will be due at the time of service.  We accept cash, personal checks and American Express, Discover, Visa, MasterCard and Care Credit.  If you are unable to pay your patient portion in full, then treatment will be postponed until you can pay.

A complete listing of all of our policies are also available for viewing at the office.