Cash Payment Policy

Payment for appointments will be charged to the credit card you upload before any appointment can be confirmed.

You agree to pay the entire cost upfront for any services scheduled, before they are provided.

You agree to pay professional fees as follows: 



Initial Intakes: (Mandatory for care)

$150 PER 45 MINUTE INTAKE SESSION



Medication Management:

$75.00 PER FOLLOW UP 



Therapy:

$150.00 PER 45 MINUTE SESSION



You agree to pay for any time spent in your, or your child's care outside of session time on a prorated basis (unless otherwise detailed below).

Unfortunately, insurance companies typically do not reimburse for this. Some examples include, but are not limited to:



* No shows/rescheduling with less than 6 business hours notice

* Phone calls, messages in the patient portal, voicemails, letters, video sessions and texts between me and: you, your child, or other physicians, therapists, teachers, family members, insurance companies, etc.

* Prescription refills outside of session time

* Time spent obtaining prior authorizations

* Coordination of care for emergencies, hospitalization, intensive outpatient, residential treatment, rehabilitation, etc.

* All forms (insurance, worker's compensation, school, employer; doctor's notes, letters, or reports) and chart reviews not filled out in session

* Testimony in court, at depositions, administrative hearings, board reviews, and all time required for preparation and travel, whether requested by you or ordered by a court, board, government agency or other legal authority

* There is a 10% finance charge each month and a $30 late fee for balances more than 30 days past due, 

and they may be submitted to collections after 30 days, along with any associated collections fees

* There is a $50 fee for returned checks (which will also result in your credit card automatically being run for the balance due) and for credit card chargebacks that are unsubstantiated.



You are financially responsible for all charges, whether or not:
* Insurance pays for any services

* We decide to proceed with treatment

* Treatment is successful, for which there cannot be any guarantee



**for in-network providers**

For in-network services, I will submit claims on your behalf as a courtesy, but there is no guarantee that your insurance will pay. 



You are responsible for full payment, whether your insurance company ends up paying partially, or not at all, for services rendered.



You affirm you are an authorized user of the credit card whose number and expiration date supplied, and you do authorize its use for all fees incurred.