Patient Information
Do you take insurance?
No, this practice is out of network (OON) for all insurance coverage. This means that payment is required at the time of service and patients are able to seek reimbursement directly from their insurance company using OON coverage. Most insurance plans offer OON benefits! Service codes can be provided to you prior to receiving services. This may allow you to check with your insurance company on how much you can plan to receive as a reimbursement rate for clinical services. A sliding scale fee is also available for those who do not have OON benefits and/or have a difficult time paying the up front costs.
How can I receive insurance reimbursements?
A superbill will be created and sent to you on a monthly basis, or more frequently as requested. This bill will have all of the codes and provider information that your insurance company will need. When you become an active patient, you will have access to the online patient portal where you can print superbills from past appointments whenever you need them for insurance submission.
Why don’t you work with insurance companies directly?
At Rise and Shine Family therapy, we value TIME and a commitment to INDIVIDUALIZED CARE. It is more important for us to be able to spend time providing quality direct service and collaborating with outsider service providers (like teachers, doctors, parents, etc) than chasing down insurance payments. We also value individualized care and can provide services with flexibility that go beyond an insurance company mandating how we can and cannot bill, document, or provide for our patients. We can offer school based consultation services, out of the office exposure work, multidisciplinary group treatment, and multiple week appointments that an insurance provider may not always cover.
What is your cancellation policy?
You will receive 2 appointment reminders for your session. One reminder comes to you 2 days before your appointment, and the other will remind you 1 hour before the appointment. Please recognize that this is a health business and as such, the full clinical fee will be charged if given less than 24 hours notice of a need to cancel. I will maintain in-person services and office hours as long as it is safe to do so for my own health, and for the health of others.
If you, your child, or someone in your close network has been exposed to illness and you feel it is unsafe to meet in person, we can shift our session to virtual if it is possible to do so. Sessions will automatically be switched to Telehealth due to illness if there is a less than 24-hour advance notice of cancellation and the session could be with the minor and/or with the parent or individual. If the session is for a minor who is ill and is unable to attend, we can have a parent-only session in lieu of the ill child. Exceptions to this will be considered for emergencies only, and may require medical documentation.
Good Faith Estimate
Please see below for the Standard Notice that we are required to give of our responsibility to provide a “Good Faith Estimate of Expected Charges” to patients who are not billing sessions directly to insurance.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is 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 questions or more information about your right to a Good Faith Estimate, visit
www.cms.gov/nosurprises or call 800-985-3059