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CAROLINA PARTNERS IN MENTAL HEALTHCARE
PAYMENT FOR HEALTH CARE AND WELLNESS SERVICES
As a courtesy
to you, Carolina Partners in Mental HealthCare, PLLC will normally
accept assignment of any insurance benefits you may have and file
health care claims directly to your insurance company. However, payment
of all applicable copays and deductibles (or any other amount not
covered by your primary insurer) is required at the time services are
rendered. Payment may be made by cash, check, credit or debit card.
Every client is asked to sign a "Financial Acceptance" agreement that
is appended to this document. If you
are unable to pay your obligation at the time of service, we may ask
you to authorize Carolina Partners to charge your credit card for any
balance due more than 60 days old. Please note that we will not charge
your credit card if there is no balance due more than 60 days old.
There will be a $25.00 service
charge for returned checks.
Notwithstanding
the former, Carolina Partners reserves the right to demand full payment
for services rendered at the time of service. If you are covered by
more than one insurance company and we receive prompt payment from your
primary insurer, Carolina Partners will normally file claims to your
secondary insurer as a courtesy to you. However, pending payment by
your primary insurer, you may be asked to make payment at the time
services are rendered of any amounts covered by your secondary insurer.
Carolina Partners in Mental HealthCare,
PLLC will not be able to file claims to your insurance company unless
you provide us with accurate and complete information about your
insurance plan. Accordingly, we ask you to review your policy carefully
and to be aware of any limitations on your benefits. You must also
promptly inform us of any changes in your insurance coverage or we will
not be able to file your claims. Similarly, many insurance companies
are now managing their mental health benefits. This means you must
consult your insurance booklet to see if your insurance must approve
sessions before they occur. If this approval is not obtained, your
insurance will not cover the sessions. If you are not sure, please ask
Carolina Partners in Mental HealthCare, PLLC to help you with these
prior authorizations.
- Please note that you are
ultimately responsible for all charges incurred for your treatment or
the treatment of those for whom you are responsible. If for any reason
your insurance company, or other third party payer (such as a divorced
spouse or lawyer), does not promptly reimburse Carolina Partners for
services rendered, you will be responsible for those charges (subject
to any applicable law or the terms of any contract we may have with
your insurer).
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