FINANCIAL AGREEMENT

The standard fee per hour of service is $110.00

When a combination of personal and insurance resources is insufficient to meet the fee, a discount charge may be accepted. This discount charge will be based on the gross family income and the number of dependents supported by that income. A limited amount of funcing received from sponsoring churches makes possible to offer a discounted charge in particular instances.

You my file for any applicable insurance reimbursement**. Sessions are normally $110.00 when insurance applies***. Any benefits received from insurance will be applied to the client's account. Benefits resulting in an overpayment will be refunded to the client. Changes in income, employment, insurance, or other life circumstances may warrant re-negotiation of the fee agreed upon.

Payment is due when services are rendered unless other prior arrangements have been made and agreed upon in writing. A charge is incurred for all missed appointments unless cancelled 24 hours in advanc or, in case of Monday appointments before 5 PM Friday.

** In certain cases

*** Certain insurance coverages occur at different fees. If you have questions about this, ask you therapist at your first session.

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