Payment, Refund, No-Show, and Billing Policy

At launch, Sky e-Clinic uses a card-on-file and post-visit charge model. A valid payment card is required at booking, but the consultation fee is not charged at booking, and is not charged before the visit except where expressly disclosed and authorized. After the clinician completes the encounter and the required documentation (including CPT and ICD-10 coding), the consultation fee is charged to the card on file through Elation Patient Payments / Stripe. The fee pays for the licensed clinician's time reviewing intake, performing the evaluation, applying clinical judgment, documenting the encounter, and providing a clinical decision or visit summary. The fee is not a prescription fee and does not guarantee a prescription, referral, lab order, work note, or specific outcome. Sky e-Clinic's fee schedule range is $50 – $400 (current operational maximum: $200); the specific fee for each visit type is displayed on the booking page and in the booking confirmation. See the Good Faith Estimate Notice for the full fee schedule and No Surprises Act disclosures.

Good Faith Estimate at scheduling. For every uninsured / self-pay patient, Sky e-Clinic provides a Good Faith Estimate at the time of scheduling through the booking confirmation email and Patient Passport notification, both of which link to the standing Good Faith Estimate Notice and display the specific fee for the visit type selected. The Notice describes Sky's full fee schedule, the card-on-file + post-visit-charge design that ensures the estimate equals the actual charge, and the federal Patient-Provider Dispute Resolution process. A copy of the booking confirmation and the Notice in effect at the time of service is retained for at least 6 years per 45 CFR 149.610(c).

• Medication costs at the pharmacy.
• Laboratory testing fees. Lab fees are paid separately at the laboratory; patients may self-pay or use their payor of choice at the lab unless Sky separately approves and publishes a different lab billing workflow.
• Imaging, urgent care, emergency care, specialists, or outside facility charges.
• Follow-up visits unless expressly included in writing.
• Insurance coverage or reimbursement. Sky e-Clinic does not bill insurance directly. Superbills (itemized receipts with ICD-10 and CPT codes) may be provided upon request so that you may submit them yourself for possible out-of-network reimbursement; reimbursement by your insurer is not guaranteed.

• Credit and debit cards (Visa, Mastercard, American Express, Discover) processed through our HIPAA-compliant payment processor (Elation Patient Payments / Stripe).
• Health Savings Account (HSA) cards.
• Flexible Spending Account (FSA) cards.
• Sky e-Clinic does not accept cash, check, or wire transfer. Side-channel payment requests (Venmo, Zelle, PayPal, Cash App, etc.) are not accepted to maintain HIPAA-compliant payment-data flow and unified reconciliation.

Because Sky e-Clinic's launch model uses card-on-file with post-visit charging, many pre-visit cancellations do not require a refund because no consultation fee has been charged yet. Refund rules at launch:

• Cancellation before the scheduled visit and before any charge has been processed: no consultation fee is charged; no refund is needed.
• Cancellation within 24 hours, no-show, or patient-side technical failure: a disclosed late-cancellation / no-show fee may be charged to the card on file if permitted by the posted policy and applicable law.
• After the clinician has completed an in-scope consultation and issued a clinical decision, the consultation fee is non-refundable, including when no prescription is issued.
• If the clinician determines that the case is outside Sky's scope or jurisdiction and the patient did not knowingly conceal the issue, Sky may waive or refund the fee.
• If the patient false-cleared explicit red-flag screening and the clinician later identifies a red flag during the encounter, the fee is generally non-refundable, subject to physician compassionate exception.
• If a red flag newly emerges during the encounter, or could not reasonably have been screened earlier, refund is at physician discretion and is typically full.
• Clinic-side failures such as a confirmed platform outage, clinician non-response beyond the published timeframe, or substantiated inappropriate conduct may be reviewed for refund or rescheduling.

Please contact support through Patient Passport before initiating a chargeback so we can review the issue. To respond to payment disputes, Sky e-Clinic submits only the minimum necessary information (such as booking records, payment timestamp, cancellation timestamp, completion status, and refund-policy text). Clinical content (diagnosis, prescription details, visit notes) is not submitted in chargeback responses without legal review.