Terms
Longleaf Counseling Terms
Cancellation and Rescheduling
24 hours notice is required to cancel or reschedule an appointment. If an appointment is canceled in less than 24 hours, the appointment will be forfeited and charged the full rate.
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 your card the full session 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.