Insurance Reimbursement is defined in Section 2.1(c).
Insurance Reimbursement. If you are choosing to use benefits provided by an insurance company, I will be required to submit information to that company in order to obtain reimbursement or authorization of services. This document serves aa a release for this purpose to bill your insurance. You should also be aware that your contract with your health insurance company requires that I provide it with information relevant to the services that I provide to you. I am required to provide a clinical diagnosis. Sometimes I am required to provide additional clinical information such as treatment plans or summaries, or copies of your entire Clinical Record. In such situations, I will make ever effort to release only the minimum information about you that is necessary. This information will become part of the insurance company files and will probably be stored in a computer. Though all insurance companies claim to keep such information confidential, I have no control over what they do with it. In some cases, they may share the information with a national medical information databank. I will provide you with a copy of any report I submit, if you request it. By signing this Agreement, you agree that I can provide requested information to your insurance carrier. Please discuss any concerns or questions you may have regarding these exceptions to confidentiality.
Insurance Reimbursement. If you have health insurance, I can fill out forms and provide you with assistance to help you receive your benefits. Please note that you, not your insurance company, are responsible for full payment of my fees. If your insurance changes, you are responsible for notifying my office of this change in writing. It is important that you find out exactly what mental health services your insurance policy covers. If you have questions about the coverage, you may choose to contact your plan administrator. Your contract with your health insurance company requires that I provide the health insurance company information relevant to the services that I provide to you. I am required to provide a clinical diagnosis. Sometimes, I am required to provide additional clinical information, such as treatment plans or summaries, or copies of your entire clinical record. In such situations, I will make every effort to release the minimum information about you that is necessary for the purpose requested. This information will become part of the insurance company files. In some cases, the insurance companies may share clinical information with a national medical information databank. I can provide you with a copy of any report I submit, at your request. By signing this Agreement, you agree that I can provide requested information to your insurance carrier.
Examples of Insurance Reimbursement in a sentence
PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay the standard fee of $150.00 per 45-60 minute session at the end of each session unless other arrangements have been made.
PAYMENTS & INSURANCE REIMBURSEMENT: Clients are expected to pay the standard fee of $105 set per 45-55 minute session at the end of each session or at the end of the month unless other arrangements have been made.
More Definitions of Insurance Reimbursement
Insurance Reimbursement is defined in Section 3.5(a) of this Agreement.
Insurance Reimbursement is defined in Section 4.1(b).
Insurance Reimbursement. For client’s with out-of-network insurance coverage, upon request, I will provide you with an appropriate document for you to submit to your insurance company in order for them to reimburse you. It is your responsibility to verify specifics of your coverage. Insurance companies may not reimburse their clients for all issues, conditions, and/or problems dealt with in psychotherapy. Agreement for Treatment: Xxxx Xxxx XxXxxx-Xxxxx, MA, PHN, LMFT # 35490 NPI: 0000000000 (cont.)
Insurance Reimbursement. For patient’s with out-of-network insurance coverage, upon request, I will provide you with an appropriate document for you to submit to your insurance company in order for them to reimburse you. It is your responsibility to verify specifics of your coverage. Insurance companies may not reimburse their patients for all issues, conditions, and/or problems dealt with in psychotherapy. Agreement for Treatment: Xxxx Xxxx XxXxxx-Xxxxx, MA, PHN, LMFT # 35490 NPI: 0000000000 (cont.) Patient(s)Name(s): Date: / / Litigation Limitation: Due to the nature of the therapeutic process and the fact that it often involves making a full disclosure with regard to many matters which may be of a confidential nature, it is agreed that should there be legal proceedings (such as, but not limited to divorce and custody disputes, injuries, lawsuits, etc.), neither the patient(s) or your attorney, nor anyone else acting on your behalf, will call on me to testify in court or at any other proceeding, nor will a disclosure of the psychotherapy records be requested unless otherwise mutually agreed upon by therapist and patient or ordered by the court. Mediation & Arbitration: All disputes arising out of or in relation to this agreement to provide psychotherapy services shall first be referred to mediation, before, and as a pre-condition of, the initiation of arbitration. The mediator shall be a neutral third party chosen by agreement between myself, and the patient(s.) The cost of such mediation, if any, shall be split equally, unless otherwise agreed upon. In the event that mediation is unsuccessful, any unresolved controversy related to this agreement shall be submitted to and settled by binding arbitration in Marin County, California in accordance with the rules of the American Arbitration Association which are in effect at the time the demand for arbitration is filed. Notwithstanding the foregoing, in the event that the patient’s account is overdue (unpaid) and there is no agreement on a payment plan, I can use legal means (court, collection agency, etc.) to obtain payment. The prevailing party in arbitration or collection proceeding shall be entitled to recover a reasonable sum as and for attorneys’ fees. In the case of arbitration the arbitrator will determine that sum. Termination: As set forth above, after the first several meetings I will assess if I can be of benefit to you. I do not accept patients who, in my opinion, I cannot help. In such a case I will give you a number of...
Insurance Reimbursement. I understand that the services offered by Modern Medicine, LLC facility does not offer an insurance option at this time. We offer services at a discount cash rate. If you request to use a insurance based option to seek reimbursement/coverage of services rendered we will be required to charge at the non-discounted insurance-based fee schedule. Addition time taken by staff/physicians for all and any forms or documentations required by your insurance company for reimbursement purposes or coverage beyond the standard request will be charged to you at the rate of $250.00 per hour.
Insurance Reimbursement. If we are providers with your insurance or managed care company, you must obtain initial authorization, communicate your mental health benefit to us, and make your co-pay at each visit and your deductible annually. If we are not providers for your insurance company or you do not have mental health coverage, you will be responsible for the entire fee at the time of the appointment. It is your responsibility to alert us of any changes in your insurance plan. If we have made all efforts to comply with your mental health insurance carrier, but the company refuses payment, or you have exhausted the limits of your policy, you will be responsible for the entire bill.
Insurance Reimbursement. If you have a health insurance policy, it may provide some coverage for occupational therapy assessment and treatment. You will be responsible for requesting a referral from your child’s pediatrician/physician in order to initiate treatment. Arbor Psychology Group (APG) will provide you with whatever assistance we can in helping you receive the benefits to which you are entitled. However, you, not your insurance company, are responsible for payment of services at the time of service(s). It is very important that you find out exactly what services your insurance policy covers. You should carefully read the section in your insurance coverage that describes occupational therapy services. If you have questions about the coverage, call your plan administrator. Of course, we will provide you with whatever information we can based on our experience and will be happy to help you in understanding the information you receive from your insurance company. If it is necessary to clear confusion, we will be willing to call the company on your behalf. I have read and understand that I am responsible for any fees that my insurance company does not cover.