Common Contracts
2 similar Treatment Agreement contracts
Treatment AgreementTreatment Agreement • July 22nd, 2024
FEES: The fee per individual 45-minute session is $225.00 due at the time of our session, unless I am billing your insurance, in which case you must pay your copayment and/or deductible at the session. Fees are the same for video, phone, or in-person sessions. CANCELLATION: Sessions are by appointment only. While I hate charging for missed sessions, I do reserve that time for you. Therefore, you will be charged the full session fee (not just a copayment) for missed sessions or for those canceled without 24-hour notice, except in medical emergencies. Insurance will not pay for missed sessions. Since your time is also valuable, if I forget a session, you get one session free. INSURANCE: I am a provider, and I will submit claims for you. In our session, you must pay any copayment or coinsurance for any portion not covered by your plan. There may be a deductible (an amount you will need to pay out of pocket) before your plan begins covering sessions. If insurance does not pay as expected,
Treatment AgreementTreatment Agreement • June 12th, 2023
FEES: The fee per individual 45-minute session is $225.00 due at the time of our session, unless I am billing your insurance, in which case you must pay your copayment and/or deductible at the session. Fees are the same for video, phone, or in-person sessions. CANCELLATION: Sessions are by appointment only. While I hate charging for missed sessions, I do reserve that time for you. Therefore, you will be charged the full session fee (not just a copayment) for missed sessions or for those canceled without 24-hour notice, except in medical emergencies. Insurance will not pay for missed sessions. Since your time is also valuable, if I forget a session, you get one session free. INSURANCE: I am a provider, and I will submit claims for you. In our session, you must pay any copayment or coinsurance for any portion not covered by your plan. There may be a deductible (an amount you will need to pay out of pocket) before your plan begins covering sessions. If insurance does not pay as expected,
