Common Contracts

1 similar Payment for Services Agreement contracts

PAYMENT FOR SERVICES AGREEMENT
Payment for Services Agreement • November 11th, 2022

Dr. Feinberg uses “Ivy Pay” for payment of services which is specifically designed for therapists and is HIPAA-compliant. Prior to your initial appointment Ivy Pay will text you a secure link to your phone leading to a page where you enter your credit card information and approve the first charge. This is not spam. Please open the text and follow the steps. A deposit of $100 will be used to secure your initial appointment. If it is not received 72 hours prior to your scheduled appointment your time slot will be cancelled. IVY Pay works with your debit card, credit card, HSA or FSA account. It is HIPAA secure and it keeps our therapeutic relationship confidential. You will only have to enter your information one time. Just like the current system, once you enter in your information it will be securely saved and after your appointment a superbill/receipt will be handed to you if your appointment is in the office or emailed if it was virtual.

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