Cancellation and Rescheduling
Your appointment time is reserved specifically for you and/or your family member. To honor this commitment and ensure availability for all clients, a minimum of 24-hours’ notice is required to reschedule or cancel an appointment.
If less than 24-hours’ notice is provided, you will be charged a $110 late-cancellation/no-show fee. Payment is expected for all scheduled appointments unless proper notice is given.
I recognize that emergencies and sudden illness can occur. In these situations, I will use discretion in determining whether to waive the cancellation fee. If possible, I will work with you to reschedule your appointment later the same day or within the same week, and in those cases, the fee will not be applied.
Please note that two consecutive missed sessions without notice will be considered a termination of our therapeutic relationship.
Payment
I require you to keep an active card on file. I will ask for you to add your card information, through our HIPPA compliant patient portal in order to reserve your first session. I will not charge your card for services rendered until after our session. If you do not show up to an appointment, or you cancel late, I will charge you our late-cancellation/no-show fee. Payment is due the day of service. If you would like to pay with cash, you will still need to keep an active card on file.
Payment Methods
I accept all major credit cards (Visa, American Express, Mastercard, Discover), Flexible Spending Accounts (FSA), and Health Savings Accounts (HSA) run through major credit cards. In some circumstances I will consider cash as a form of payment.
Good Faith Estimate
On January 1, 2022, congress enacted a "No Surprises Act", which is a "new federal protection against surprise medical bills that take effect in 2022. Surprise medical bills arise when consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose". Under the law, healthcare providers, including mental health providers, must give clients who are not using insurance an estimate of the bill for services.
You have the right to receive a Good Faith Estimate explaining how much your mental health care may cost. Under the No Surprises Act, Longleaf Counseling must provide clients who do not have insurance (uninsured) or who will not be using insurance to pay or reimburse for services (self-pay) an estimate of the total expected costs for services. You can ask Longleaf Counseling for a Good Faith Estimate before you schedule a service.
If you receive a bill at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.
If you have any questions about how this affects your care, please contact Longleaf Counseling at (980) 397-2519.