Financial Policy

PAYMENT

Payment is required before services are rendered. We will accept cash and/or credit cards. Payment will include any unmet deductible, co-insurance, co-payment amount, or non-covered charges from your insurance company. If you do not carry insurance, or if your coverage is currently under a pre-existing condition clause, payment in full is expected at the time of you visit.

INSURANCE

We are participating providers with several insurance plans. We will file all of these insurance claims. A list of these insurance plans is available upon request. Please remember that insurance is a contract between the patient and the insurance company and ultimately the patient is responsible for payment in full.

CANCELLATIONS OR MISSED APPOINTMENTS

Broken appointments represent a cost to us, to you and to other patients who could have been seen in the time set aside for you. If you do not cancel your appointment at least 24 hours before, or if you no-show, we will charge you a $25 missed appointment fee. Excessive abuse of scheduled appointments may result in discharge from the practice.

FORMS FEES

Completing insurance forms, copying medical records, writing letters etc. requires office staff time and time away from patient care we require pre-payment for completing forms, copying medical records, notarizing, or for extra written communication by the clinician. The charge is determined by the complexity of the form, letter, or communication. Base form letter charges are $30.00 per page plus and applicable postage or notary fees. Postage is additional and payment is required in advance. Copying fees for Medical Records is .75 cents for each page. Alssaro Counseling Services, PLLC will have 15 business days in which to copy records before making them available for patient to pick up, and these 15 days will commence after payment for copying has been received and after patient has signed this form authorizing records’ release.