Services

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Payment of Fees: payment for services as described in this agreement. Clients agree to the following:

• Payment for sessions with providers affiliated with Practice is payable online through debit or credit card or ACH transfer, unless otherwise established
• Payment for sessions is due after each session unless otherwise agreed upon and Practice will charge my card or bank account for my responsibility. Receipts may be provided at the time of the charge or monthly
• I will be charged for sessions that I do not keep, unless I provide enough notice to the provider affiliated with the Practice (your treating provider will tell you how much notice is required to avoid being charged for sessions you do not keep)
• I understand that I cannot submit bills for cancellations to my insurance company or managed care plan

Insurance and Managed Care Plans: Practice participates in a number of insurance and managed care plans. If Practice participates in my plan, I agree to pay all applicable deductibles, co-payments, co-insurances and any other form of cost-sharing. If my insurance benefits run out, Practice will inform me of the ending date, and I will then be responsible for all charges dating from the end of insurance coverage. If my insurance plan denies the visit despite Practice following necessary procedures, I understand I may be responsible to pay in full for the services.

Late Cancellations and No Shows: The $75 cancellation and no-show fee is often non-negotiable but below are instances of isolated emergencies in which the cancellation fee may be waived:

True, Unforeseen Emergencies
​These are events that are sudden, severe, and genuinely prevents the client from giving advanced 24hr notice prior to a cancellation or no show. The following are considered unforeseen, acute, and unavoidable events.

• Sudden Medical Crisis: An acute, severe illness (e.g., sudden high fever, debilitating migraine) or a sudden hospitalization of the client or a critical, immediate family member.
• ​Car Accident: The client is involved in a motor vehicle accident on the way to the session.
• Death in the Immediate Family: A sudden and unexpected death of a close family member.
• Natural Disaster/Severe Weather: Dangerous or sudden severe weather conditions (e.g., flash flood, heavy snow) that make travel unsafe or cut off utilities/internet access for telehealth.

*Cancelation/No Show fees may also be avoided if the client requests to convert their appointment to telehealth