Financial Agreement

Financial Agreement and No Show/Late Cancellation Agreement:

Appointments

Appointments must be cancelled or rescheduled at least 24 hours in advance in order to avoid a cancellation fee ($50).


Please note that missed appointments are not reimbursed by insurance companies and you will be subject to a no show or late cancellation fee based on level of care. Exceptions may be made for extenuating circumstances only. Please also note that this fee must be paid before your next appointment.

Payments

If your insurance plan requires you to pay a co-pay, deductible, or coinsurance, please be aware that the payment must be paid in full on the day of your visit. We reserve the right to not reschedule an appointment with you should you have an outstanding balance on your account. In extreme cases, large running balances may result in termination of services and your account may be turned over to a collection agency should the need arise. Co-pays not paid within 2 days of your visit will result in a $15 charge.

Insurance

Some insurance plans require a referral from your primary care doctor or authorization from your insurance company. You are responsible for knowing your mental health coverage benefits in order to ensure your visit with the provider is covered. We do accept most major insurances so please make sure we have your most current insurance card on file. Should your plan change, please notify our office immediately. If you have questions regarding other insurance plans, please ask.

Self Pay Rates (paying out of pocket):

Evaluation/ First Appointment-

  • $320 (NP and PA)
  • $250 (Therapy)

Follow ups:

  • $175 (NP and PA)
  • $250 (Therapy)