Fees and Billing
Initial Appointment $ 112.00
Counseling session: $ 90.00
Court ordered testing: $ 850.00
Educational testing: $ 650.00
lap band / bariatric psychological screening: $ 300.00
Mental Health Resources, P.C. is an association of independent mental health professionals in private practice. The responsible party for this account is to provide complete and accurate information for billing and for filing insurance claims. It is the Responsible Party’s responsibility to provide the Administration Office with any change of information, as soon as possible, and to complete any necessary forms.
is expected at the time services are rendered. This includes insurance
deductibles, co-pays or the amount not covered by insurance. A monthly billing
statement will be sent to you in regard to the status of the account and
outstanding balance. The balance is due at the time the statement is received
unless other financial arrangements are made with the administrative office.
Our office cannot legally enforce any court orders regarding payment for
services by third-parties. Therefore, you should expect to make complete
payment for all fees and charges on your account. If your account should become
over paid, a refund will be processed during the next quarter. A charge will be
assessed for appointments missed without cancellation within a period of 24
hours. These fees can be waived at the
discretion of the provider.
INSURANCE: Primary and Secondary Insurance is billed by a billing service contracted by Mental Health Resources, P.C. as a courtesy to our clients. Your insurance benefits will be verified prior to your first appointment to be certain coverage is in force and that your provider is able to bill for services under your contract. Insurance policies are contracts between you (or your employer) and the insurance company, therefore, it is your responsibility to understand your insurance policy requirements and limitations. Please take the time to verify your insurance benefits. We cannot guarantee payment of claims.
are responsible for and expected to pay deductible, insured portion for
"in network" carriers or for the difference between the amount that
the "out of network" carrier pays and the amount of the charge. A
copy of the insurance card is required and you are to supply all information
necessary for billing agent to file the insurance claim.
PSYCHOLOGICAL EVALUATION OR TESTING: the charges are based on the time for administering the tests and interpreting the test results, necessary and appropriate interviews and preparing a report. The total cost may not be known until the evaluation testing is completed. However, a payment on account towards the total charges is required on or before the date of service. If a third party, such as a school system, has agreed to pay for the evaluation, you must provide appropriate documentation of the third party’s agreement to pay, prior to the date of service.
COURT ORDERED EVALUATIONS:
MENTAL HEALTH RESOURCES DOES NOT FILE CLAIMS FOR COURT ORDERED EVALUATIONS or OTHER COURT RELATED EVALUATIONS THAT DO NOT MEET CRITERIA FOR MEDICAL NECISSITY.
Mental Health Resources, P.C. policy for Court ordered or court related evaluations is as follows:
Before the date of evaluation, you must provide:
1) Copy of Court Order
2) $850.00 payment per person being tested; or
3) Letter from attorney stating that the attorney will pay for all the testing charges and giving billing information; or
4) Letter from outside agency stating that they will pay for part or all testing charges.
The responsible party agrees to pay for all charges not covered by this letter.
COURT APPEARANCE OR TESTIMONY is billed at an hourly rate, portal to portal, plus mileage and expenses. Court preparation time as well as time spent consulting with attorneys will also be billed.
A copying and file preparation charge will be billed for records or other materials subpoenaed. The individual requesting this activity must sign a separate agreement giving billing information prior to the mental health professional taking action on requests. This person will be billed separately from regular charges and payment is due in full upon receipt of statement.
NO SHOW OR CANCELLATION of a scheduled appointment with less than 24 hours notice will result in a charge for time scheduled. You will be expected to pay in the next billing cycle as insurance companies do not cover this charge. If you dispute a charge, please address this with your therapist.
RETURN CHECK Charge of $25.00 (twenty-five) will be applied to your account and the payment amount and the payment amount will be reversed on the account for any payments that are returned to us. In addition, we may require cash payments for services rendered in the future.
DELINQUENT ACCOUNT will be referred to an outside agency. Any fees and costs will be added to the account to cover the cost of the collection and you will be responsible for these and any court costs incurred.
CHANGES: You are responsible for reporting to us any changes in your address, phone number(s), insurance and billing information.
You will be responsible for any charges that are unpaid due to failure to report such changes.