POLICIES
PAYMENT: Payment is required at the time services
are rendered. Acceptable methods of payment include cash, check,
and credit card.
INSURANCE: Insurance co-payments are due at
the time of service. In addition, if your insurance deductible
has not yet been met, you will be billed the full charge for services.
As a service to you, we may bill your insurance. However, we cannot
guarantee insurance coverage. Please be advised that in some instances,
insurance companies refuse to pay for services for whatever reason.
You are responsible for all fees not covered by your insurance.
Certain information, including type of treatment, costs, dates,
and providers, may be shared with your insurance company for reimbursement
purposes.
OUTSTANDING BALANCE: You are responsible for
paying any outstanding balances that insurance companies have
not covered. Once we receive an Explanation of Benefits from your
insurance company, we may need to adjust your balance based on
the contracted rate. If you discontinue treatment, you are still
responsible for outstanding balances on your account. Please be
advised that if your clinician does not receive payment for services,
she may discontinue your treatment.
THIRD PARTY PAYMENT: If your parent or legal
guardian is paying for treatment, they must make financial arrangements
with our Office Manager and sign a third party financial agreement
prior to your next appointment.
LATE FEES: A late fee of $25 will be charged
to accounts that are not paid by the due date indicated on your
first bill. If payment is not received by the third due date,
your delinquent account will be referred to collections and you
will be responsible for all associated collections and legal fees.
CANCELLATIONS / NO SHOWS: You will be charged
a rate of $50 for a missed appointment or cancellation with less
than 1 business day notice, i.e. Monday appointments need to be
cancelled by the preceding Friday.
RETURNED CHECK: In the event that a check is returned, you will
be charged a $35 fee, in addition to any bank fees. In the event
that a second check is returned, you will be charged the same
fees and have to arrange another method of payment.
PHONE CALLS: Typically there is no charge for
phone calls. However, phone calls that are extended or constitute
therapy may be billed at our standard hourly rate, depending on
the circumstances.
PSYCHOLOGICAL TESTING: It is often the case
that for psychological testing insurance companies will not reimburse
or will reimburse at such a minimal rate that we are not compensated
for our time and/or materials. In this event, you are responsible
for all testing charges.
ADDITIONAL SERVICES: In some circumstances,
depending on the time involved and nature of task, you may be
charged for additional services, such as extended sessions, scoring
psych testing, preparing a psych report, writing letters of advocacy
or documentation on your behalf, and extended consultation with
other providers regarding your treatment.
Please address any questions regarding financial policies with
the Office Manager. |