No one likes to read the fine print, but it’s really important, if we’re going to work together, that you have a clear understanding of the business end of my practice (in fact, it’s required by the Ohio State Psychology Board). Please read the following material carefully, and don’t hesitate to ask any questions you might have.
Please Read Carefully! My office handles health insurance differently than many health care providers. By choice, I have not contracted with any insurance companies, and consequently am an “out of network” provider. If you are relying upon your health insurance to cover or defray the cost of our services, we recommend that you check your policy’s provision for out of network providers. Also, I am an “opted out” provider and do not accept Medicare.
We ask our clients to pay for services directly, and to submit health insurance claims for reimbursement. It will be your responsibility to manage the mechanics of your insurance claim. Accordingly, we do not accept direct assignment of payment from insurance carriers. Our role will be to assist you in any reasonable way possible. We will supply you monthly with a HCFA (universal) health insurance claim form, completed with all necessary provider information and codes. You can then submit these claim forms to your carrier directly for reimbursement.
We will do our best to assist you if you have questions regarding matters related to billing and insurance. However, we stress that the mechanics and management of collecting from health insurance carriers are the client’s responsibility.
Fees and Billing
Payment for an initial consultation is required either before or at the time of the office visit. Payment for subsequent services can be arranged in several different ways, according to your convenience. Payment may be made at the time of office visits, made by credit card, or billed at the end of the month. If you chose to be billed monthly, I ask that you settle your account in a timely fashion, no later than the end of the following month. The Office Billing Forms allow you to specify how you would like to handle billing arrangements.
Here is my current schedule of fees:
|Office visit (45-50 minutes)||$175|
|Extended time visits||Office visit rate, pro rata|
|E-mail / telephone consultation||Office visit rate, pro rata|
If you decide to schedule an initial consultation, you will need to go to the Forms page of this web site to download, complete, and return the Office Billing Forms. You can return these forms by email attachment, or through conventional mail.
If another party is responsible for paying all or part of your charges, it is necessary for that individual to also complete a copy of our Office Billing forms. Please have that individual contact our office by phone at 216-751-1007, or by contacting us.
Forty Eight hours (two business days) cancellation notice is required for appointment times reserved. Should you cancel with less than 48 hours notice, we will do our best to fill the appointment hour. If we are unable to, your account will be billed the fee for the time reserved.
As I mentioned at the beginning, please don’t hesitate to raise any questions or concerns that you have regarding billing and insurance.