Private Pay. Home Care Assistants providing services to Private Pay clients will be paid $17.27/hour for Private Pay hours served OR their regular rate of pay if their regular rate of pay including differentials exceeds $17.27/hour. The $17.27/hour rate is intended to be a flat rate and not to be inclusive of other differentials. This rate is intended to be in effect for Private Pay clients who are paying our regular, hourly Private Pay rate. This rate is not intended for services provided at DESC, Seattle Housing Authority, or other low-income housing settings where Full Life Care is providing Private Pay services at a discounted rate. In those situations, an HCA’s regular rate of pay would apply or, in the case of DESC, the special DESC wage rate would apply. Effective January 1, 2023 and annually thereafter, the rate shall be adjusted to reflect the Seattle minimum wage.
Private Pay. The patient has no insurance and is responsible for all health care costs. AUTHORIZATION STATEMENT I authorize the office to release any information to any insurance company, adjuster, or attorney that will assist in the payment of a claim. I fully understand and agree that insurance policies are an arrangement between the insurance carrier and myself. I will be responsible for any expenses not paid by insurance. A photocopy of this form shall be valid as the original.
Private Pay. Clearview agrees to provide certain basic services and supplies to you in exchange for the payment of a daily rate. Your daily rate is determined by the level of services Clearview provides to you. This rate is subject to change if you require a different level of care or if the rates change.
Private Pay. Prior to the service, we will provide you with a Good Faith Estimate. This will give you the codes for the service so that you can check with your insurance carrier about reimbursement. It will provide the expected cost to be collected prior to or on the date of service. Payment will be expected at the time of service, and as applicable upon final billing, unless otherwise arranged in advance.
Private Pay. To the extent possible, Consultant shall limit marketing efforts to patients who are not enrolled in a Medicaid managed care plan or other federally funded healthcare program.
Private Pay. To access substitute hours as a private pay option, the following must apply:
Private Pay. If you are not eligible for Medicare or Medicaid, you will pay a monthly fee to Trinity Health PACE Alexandria. Your monthly premium of $ starts on (date). Because this fee does not include the cost of Medicare prescription drug coverage, you will be responsible for an additional monthly fee for Medicare prescription drug coverage in the amount of $ . . You may pay both premiums together, or you may contact your Social Worker for additional payment options.
Private Pay. Families who do not have insurance coverage for ABA may choose to pay privately for ABA Therapy. Services are billed in advance on a month-to-month basis for your pre-scheduled ABA Therapy sessions. Prepaid fees are nonrefundable in absences. Our fees are comparable to those of other highly qualified specialists. A list of rates can be requested from the Clinical Director.
Private Pay. Resident agrees to pay Amsterdam’s published Basic Rate of $618.00 per day for a semi-private room, $658.00 per day for a private room without a shower, $695.00 per day for a private room with a shower, or $775.00 for a private suite for the Basic Services listed in Section A(l) of this Agreement, and Amsterdam’s charges for the services and items listed in Section A (2) of this Agreement that are not included in the Basic Rates and not paid for by Medicaid, Medicare or other third-party insurance. Resident, Resident Representative and/or Sponsor also agree to pay (in accordance with the terms of this Agreement) Amsterdam for any applicable co-payments and deductibles or other services and items furnished by Amsterdam that are not covered by Medigap, Medicaid, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Commercial Insurance, or Managed Care Providers.
Private Pay. If we have agreed to a private pay arrangement, the charge per session will be due at the time of each session. Payment must be made by cash or check made out directly to Xxx Xxxxxxxxxxx, Psy.D. In certain circumstances, such as if another party is paying for your treatment, I will be happy to set up a monthly invoicing by mail. I will provide you, or other responsible party, with professional invoices or receipts for all services provided. Insurance Billing In order for me to devote my time to patient care, I have contracted with a professional billing service to process all insurance claims. The way this works is that I will send the initial billing information you provide me to this service through a secure web-based portal that meets privacy and security standards set out by law. Once the billing company has the initial information in their system, they will be able to handle all issues related to billing your insurance company for treatment. After each session, I will send them the minimum information required by your insurance company to process the claim. This information typically includes your name, the date of service, the general type of service provided (e.g. “55-minute Psychotherapy Session”), and a diagnosis code. I have a contract in place with the billing service that requires them to maintain the privacy and security of your information to the highest standards required by law. Although it is important that you understand any limits to your benefits prior to beginning treatment, the professional billing service I have hired will also be able to help determine eligibility for treatment and any limitations at the outset of our work together if any questions arise. If you have any further questions or concerns about my billing practices, please feel free to ask and I will be happy to provide you with additional information.
