Insurance Billing AgreementInsurance Billing Agreement • June 18th, 2024
At this time, Christina Smith, LCSW is a credentialed provider for several insurance companies. Please contact Christina Smith, LCSW to see if she is a provider with your insurance and then check with your insurance company to determine coverage for mental health benefits. Your insurance may require you to cover a co-pay (to be paid at time of counseling session) and/or be limited to a certain amount of sessions. Please know that Christina Smith, LCSW uses a third-party billing company (Gem State Medical Billing, LLC) to process billing claims. You may receive correspondence from them.
INSURANCE BILLING AGREEMENTInsurance Billing Agreement • January 2nd, 2021
INSURANCE BILLING AGREEMENTInsurance Billing Agreement • January 2nd, 2021
Insurance Billing AgreementInsurance Billing Agreement • January 1st, 2014
BE ADVISED THAT BY SIGNING FOR US TO BILL YOUR INSURANCE COMPANY YOU UNDERSTAND THAT AUDITORS FROM THAT COMPANY HAVE THE RIGHT TO COME IN AND INSPECT AND READYOUR FILE. ALL YOUR DIAGNOSTIC INFORMATION IS SUBMITTED TO THEM AFTER EACH SESSION. CONFIDENTIALITY IS NOT PRESERVED WHEN INSURANCE COMPANIES ARE BILLED. IF YOU DO NOT WANT US TO BILL YOUR INSURANCE COMPANY YOU WILL BE RESPONSIBLE FOR THE FULL COST OF SERVICES AT EACH SESSION. IN ADDITION, BY SIGNING THIS DOCUMENT YOU AGREE TO TAKE FULL FINANCIAL RESPONSIBILITY FOR ANY SESSION FEES DECLINED COVERAGE BY YOUR INSURANCE COMPANY.
Insurance Billing AgreementInsurance Billing Agreement • January 14th, 2022
INSURANCE BILLING AGREEMENTInsurance Billing Agreement • October 4th, 2011
