Fees and Services. 1. Reimbursement of a subgrantee’s insurance deductible, not to exceed $2,500.
Fees and Services. Consultation (in person, on phone, or electronic) $150.00 per hour Behavior Therapy and Treatment Planning $150.00 per hour Assessment Review $150.00 per hour Record Retrieval $ 10.00 per request Photocopy Charge for Prior Records (if requested) $ 0.15 per page Payments and Insurance Coverage: Sessions canceled with less then 24 hours advance notice will be charged a $75.00 no show fee. Charges for late cancellations or missed appointments will be solely the responsibility of the client. Insurance will not cover such expenses. In addition, it is our policy that frequent missed appointments may result in discontinuation of treatment. Payment is expected at the time service is rendered. For services covered by insurance, Monocacy Start Center will submit on the client’s behalf, and accept assignment of insurance payment. For in-network services, client is responsible for the allowed portion of charges not paid for by insurance. For out of network services, client is responsible for charges not paid by insurance. If preauthorization is needed, Monocacy Start Center will complete required treatment request forms. Charges shown by statements are agreed to be correct and reasonable unless protested in writing within 60 days of billing date. Balances over thirty (30) days past due will be charged interest at the rate of 1% per month. Treatment may cease if payment is not made in a timely manner. Clients are responsible to pay for services rendered, including reasonable attorney’s fees and costs of collection in the event of default. By signing below: I/we demonstrate that I/we understand and agree to the above policies and agree to pay for all fees and charges I/we certify that I/we have the legal right to do so and hereby authorize Monocacy Start Center to provide assessment and treatment for my child _______________________________________________ Xxxxx’s full name and date of birth ___________________________________/___________ _________________________________/___________ First Responsible Party’s Printed Name Date First Responsible Party’s Signature Date ___________________________________/___________ _________________________________/___________
Fees and Services. $20/session—Group Counseling (sliding scale not utilized) $100/hour—Individual/marriage/family/play therapy; nutrition; creative arts, financial Massage pricing—contact KellyAnne Clinical Massage
Fees and Services. 6.1. If the Buyer is a Buyer of a Product/Service the Buyer will pay a fee to use that Product/Service. All payments by Buyers for the Products/Services must be paid by BACS or cheque made payable to Datagraphic Limited and sent to Datagraphic Limited, Xxxxxxx Xxxx, Xxxxx, XX00 0XX. Quotations for Products or a service which includes printing are made subject to the suitability and availability of drawings, proofs or other instructions to be provided by the Buyer to the Company and of any Supplied Items (whether charged to the Company or not) and of any materials to be supplied by the Company which are specially requested by the Buyer and which are not normally used by the Company in the course of its business.
Fees and Services. The annual subscription fee and set-up costs may change from time to time, but such changes will not apply to you until the next annual renewal of your subscription. We offer a 30 days cooling period upon subscription agreement signature to cancel your commercial account and request membership refund; beyond this period no refunds or credits will be extended.
Fees and Services. 5.1. Following an assessment of your care needs the Total Fee that we will charge based on your current needs is £ [insert fee] per week.
Fees and Services. 1. Reimbursement of a Subrecipient’s insurance deductible, not to exceed $2,500.
Fees and Services. 1. Smart Clinic shall charge fees only within prices listed in Section 2, unless otherwise agreed.
Fees and Services. 1.1 Supplier will guarantee Tester availability for GCT. GCT will get first priority to continue using the Tester beyond the MGLL.
Fees and Services. 10.0 The Company may charge fees for services provided to Supplier hereunder and pursuant to the Company’s Terms and Conditions as set forth in Exhibit A. The Company shall have the right to deduct any amounts owed by Supplier to the Company, which are thirty (30) days or more past due, from any amounts collected in the normal course of business by the Company on the Supplier’s behalf. Amounts subject to a good faith dispute will not be subject to deduction.
