1. Purpose
This policy outlines the conditions under which clients who have paid for a Testosterone Replacement Therapy or Hormone Replacement Therapy plan and they are determined not to qualify for TRT or HRT. Clients will receive a refund of the difference between the total cost of TRT/HRT service package and the cost of the standard laboratory fee of $109.
2. Scope
The policy applies to all clients who:
- Have been billed the TRT or HRT package, that includes $109 laboratory fee.
- The at-home laboratory kit has been shipped to client.Receive a clinical determination that they
- Receive a clinical determination that they do not meet the medical criteria for HRT or TRT.
3. Definitions
| Term | Definition |
|---|
| Laboratory Fee | The fixed charge of $109 covering blood, saliva, or urine tests required for HRT/TRT assessment. |
| Total Package Cost | The full price quoted to the patient for the HRT/TRT program (including labs, consultations, medication, and any ancillary services). |
| Refund Amount | The monetary difference calculated as Total Package Cost – $109 labs that will be returned to the patient when they are deemed ineligible for HRT/TRT. |
| Eligibility Determination | The clinical decision made by a licensed provider after reviewing lab results and medical history, confirming that the patient does not meet established criteria for HRT/TRT. |
4. Refund Eligibility Criteria
A client qualifies for a refund when all of the following conditions are met:
- Payment and Ordering: The patient has paid for treatment plan and the Tasso kit has been shipped.
- Non‑Qualification: The treating clinician documents, in the patient’s medical record, that the patient does not qualify for HRT or TRT based on lab results, contraindications, or other medical considerations.
- No Additional Services Rendered: The patient has not received any billable services beyond the laboratory work (e.g., medication dispensing, additional consultations, or follow‑up appointments).
If any billable service beyond the lab fee has been provided, the patient will be refunded only for the portion of the package that remains unrendered, prorated according to the original pricing schedule.
5. Refund Process
Documentation:
- The provider completes a “Non‑Qualification Notice” in the electronic health record (EHR), indicating the reason for ineligibility.
- The billing department verifies that only the $109 lab fee has been charged.
Calculation:
- Refund Amount = Total Package Cost – $109
- Example: If the total package was $799, the refund would be $690.
Approval:
- The supervisor reviews the calculation and signs off on the refund request.
Disbursement:
- Refunds are processed via the original payment method (credit/debit card, ACH, or PayPal) within 5–10 business days of approval.
- Clients receive an email confirmation with the refund amount.
Record Keeping:
- All refund transactions are logged in the billing system and attached to the client’s chart for audit purposes.
6. Exceptions & Special Cases
| Situation | Policy |
|---|
| Patient Cancels Before Lab Kit Shipped | A full refund of $109 (lab fee) will be processed due to cancellation prior to shipping. |
| | |
| Administrative Errors | If the clinic mistakenly charges more than $109 before the eligibility determination, the excess amount will be refunded in full, regardless of qualification status. |
7. Communication to Clients
- Pre‑Visit Disclosure: At the time of payment, clients are informed that the $109 lab fee is non‑refundable.
- Post‑Result Notification: If a client does not qualify, the provider explains the result, provides a verbal “Non‑Qualification Notice,” and outlines the refund timeline.
- Refund Confirmation: An automated email is sent once the refund is processed, including contact information for any follow‑up questions.
8. Appeals
Clients who disagree with the non‑qualification determination may:
- Request a second clinical review within 14 days of receiving the notice.
- If the second review confirms non‑qualification, the original refund process proceeds unchanged.
- If the second review determines eligibility, the patient will be offered the full HRT/TRT package at the originally quoted price, and no refund will be issued.
Contact Information
For questions regarding this policy or individual refunds, please contact: support@gen3health.com
