INSURANCE and PAYMENT INFORMATION

COMMONLY BILLED INSURANCES:

This list is not all inclusive.  If you do not see your insurance company on this list, please call the number on the back of your card to verify if we are in network.

We offer a sliding fee scale for patients with no insurance and the rate is based on proof of income level and family size.

We accept these forms of payment: checks, money orders, cash, and these credit cards:

        

Co-Pay/Coinsurance/Deductible

It is your responsibility to know your insurance benefits. You can call the customer service number on your insurance card and ask for your "mental health benefits in an office setting", specifically if you have: co-pay, deductible and/or co-insurance, any limits on number of sessions per policy period, and any authorization requirements for counseling or psychological testing.

It is our policy to collect your CO-PAYMENT at the time of service. If you have a DEDUCTIBLE and/or CO-INSURANCE, we will submit the claim for service to your insurance company, and when we receive the Coordination of Benefits/Explanation of Benefits statement (with or without payment from your health insurance company), we will send you a statement indicating your payment-due amount. In the event your insurance does not pay, the patient is ultimately responsible for the charges.

The billing statements to you go out during the first week of each month, and payment is due by the end of the month.  You can mail your payment, call us to take a payment by credit card (we do NOT store/save card numbers/information), or bring cash and pay at your next appointment (if it is within the current month). If you choose to pay with cash, please bring the exact amount. We do not make change or carry credit amounts on your account.

Additional Administrative Fees/Charges:

  1. Letter writing on behalf of the patient/client will be billed at $175 per hour.
  2. Telephone calls made on behalf of the patient/client will be billed at $175 per hour after five minutes
  3. Electronic communications/E-mails made on behalf of the patient/client will be billed at $175 per hour after five minutes.
  4. Excessive postage costs for mailing documents will be assessed to the patient/client.
  5. Copying of notes, assessments, or other legal documents will be billed as:  1-20 pages/$2.50 per page, single sided; 20-60 pages/$0.15 per page, single sided. 
  6. Written requests for copying of documents are required, and must include:  date of request; patient name, address, telephone/contact information; patient date of birth; dates of treatment; description of information you would like copied.