Private Billing Sample Clauses

Private Billing. In the event you agree to pay STILLPOINT COUNSELING ASSOCIATES privately for treatment, you will be billed based on our standard rates for services and timely payments must be made in accordance to the rates set forth in Exhibit D. You should also be aware that most insurance companies require you to authorize STILLPOINT COUNSELING ASSOCIATES to provide them with a clinical diagnosis (diagnoses are technical terms that describe the nature of your problems and whether they are short-term or long-term in nature. All diagnoses come from the diagnostic manual entitled the DSM-V). Sometimes, we have to provide additional clinical information such as treatment plans or summaries, or copies of the patients entire clinical record (this is rare). This information will become part of the insurance company files and will probably be stored in their computer system. Though all insurance companies claim to keep such information confidential, we have no control over what they do with it once it is requested and received. We will provide you a copy of any report or summary we submit, if you requested in writing. By signing this agreement, you agree that STILLPOINT COUNSELING ASSOCIATES can provide the requested information to you carrier if you plan to use insurance funding to pay for treatment. In addition, if you plan to use your insurance, authorization from the insurance company may be required before they will cover therapy fees. If you did not obtain authorization and it is required, you may be responsible for full payment of the fee. Many policies leave a percentage of the fee (which is called co-insurance) or a flat dollar amount (referred to as co-payment) to be covered by the patient. Either amount is to be billed or payed to STILLPOINT COUNSELING ASSOCIATES by the due date listed on your invoices. In addition, some insurance companies also have a deductible, which is an out-of-pocket amount that must be paid by the patient before the insurance companies are willing to begin paying any amount for services. This will typically mean that you will be responsible to pay for initial sessions until your deductible has been met. It is important to note, that many deductible amounts may also need to be met at the start of each calendar year, meaning that new deductibles start January 1st of each new year. Once we have all of the information about your insurance coverage, we will discuss what we can reasonably expect to accomplish with the benefits that are available an...

Private Billing. Consultant to prepare all invoices and follow-up mailings. Initial invoicing with both English and Spanish instructions will be on 8X11 xxxxxxxx and will be placed in envelopes, sealed and mailed, postage prepaid. Initial invoicing occurs within three (3) days of receipt of transport tickets. Toll Free 800 telephone number provided to patients. An initial telephone call will also be made at this time to elicit any insurance information from the patient or patient's family. If no answer on this call is received, Consultant will send an inquiry letter in addition to the initial invoice. The standard bill schedule is as follows: • Invoice - Immediately • Statement - 30 days • Past Due - 20 days • Final Demand - 10 days

Private Billing. Xxxxxxx Enterprises to prepare all invoices and follow-up mailings. Initial invoicing with both English and Spanish instructions will be on 8 X 11 xxxxxxxx and will be placed in envelopes, sealed and mailed, postage prepaid. Initial invoicing occurs within three (3) days of receipt of transport tickets. Toll Free 800 telephone number provided to patients. An initial telephone call will also be made at this time to elicit any insurance information from the patient or patient’s family. If we receive no answer on this call, Xxxxxxx’x will send an inquiry letter in addition to the initial invoice. The standard xxxx schedule is as follows: Private Xxxx Schedule