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Payment Policy
Patients are required to pay all fees in full at the time service is rendered unless other arrangements have been made with your therapist. A completed insurance form can be provided to you so that you may file a claim for direct reimbursement from your insurance company. If you are covered by a managed care company, and authorized for visits, please provide a copy of your insurance card to the secretary. You will also be required to sign the assignment of benefits statement below and pay your co-payment at each visit. If you have an unmet deductible, you will be required to pay for the services rendered in full until the deductible has been met. Documentation can be provided for patients wishing to file claims with their secondary insurers.
Insurance policies are quite varied, and it is your responsibility to familiarize yourself with your insurance benefits, including obtaining any pre-authorizations required and verifying coverage. It is important to realize that, regardless of your insurance coverage, it is the patient (or their adult parent/guardian) who is ultimately responsible for payment of services. We will attempt to accommodate your insurance needs. However, if payment is denied you will be held responsible for the charges you incurred.
Payments are generally accepted in the form of cash, check or major credit cards. Please make all checks payable to your therapist. For any returned checks, the patient will be charged a $35.00 fee. In the event of default, your account may be turned over to a collection agency. If your account is delinquent beyond 90 days, you may be assessed a delinquency fee of 30% of the balance.
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