Fees and Payments
We accept self-pay either by cash, credit card, or check. We have funding with the United Way Fairfield County and Fairfield County ADAMH Board.
FEES (Effective 7/1/23):
You are expected to pay at the beginning of each session including co-pays and co-insurance. If you do not pay at the time of the session, you will be billed at the full rate. Some or all of the fees for treatment services may be covered by your health insurance, local mental health board (ADAMH), grants, Medicaid, or Medicare; please find out the details of your coverage from your insurance company. However, you are responsible for payment, not the insurance company. Please discuss with our billing staff any problems you may have meeting this requirement. Fees are listed below:
|PSYCHIATRIC DIAGNOSTIC EVALUATION**
|FAMILY PSYCHOTHERAPY (26+ minutes)
|PERSONAL GROWH INTAKE
|PERSONAL GROWTH COUNSELING
|CASE MANAGEMENT GROUP/GROUP THERAPY**
|CASE MANAGEMENT (Coordination of Care)
|THERAPEUTIC BEHAVIORAL SERVICES (Community Based)
|THERAPEUTIC BEHAVIORAL SERVICES (Office Based)
|SCREENING (based on presenting issue and payor)
|CONSULTATION SUMMARY/REPORT WRITING
|REVIEW OF CASE RELATED RECORDS
|CASE RELATED CORRESPONDENCE
** May include an add-on code interactive complexity ($13.81/hr)
If you become involved in legal proceedings that require agency participation, you will be expected to pay for all of our professional time, including preparation and transportation costs, even if agency staff is called to testify by another party. You will be charged $135 per hour for these activities. Insurance, Medicaid and Medicare do not pay for these services. If you request that other documents be completed for other entities, you will also be charged $90 per hour for the completion of these documents.
You will receive a monthly statement itemizing all charges and payments if you owe a balance. If there is a balance due, it must be paid in full, unless other payment arrangements have been made with the agency billing department. Your services may be suspended if your balance is more than $350. Once you have paid off your balance your treatment may resume. Accounts overdue by more than 60 days may be sent to a collection agency and may result in termination of treatment.
Misunderstandings about money can arise. If there are payment problems that have not been discussed, you and your clinician may become uncomfortable and your work together may suffer. Our contract is that the clinician helps you work on your problems and you pay for that service.
BILLING AND PAYMENTS:
You will be expected to pay for each session at the time it is held, unless we agree otherwise or unless you have insurance coverage that requires another arrangement. Payment schedules for other professional services will be agreed to when they are requested.
If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, we have the option of using legal means to secure the payment. This may involve hiring a collection agency or going through small claims court which will require the agency to disclose otherwise confidential information. In most collection situations, the only information we release regarding a client’s treatment is his/her name, last known address, the nature of services provided, and the amount due. If such legal action is necessary, its costs will be included in the claim.
For a list of accepted insurances click here.
GOOD FAITH ESTIMATE:
You have the right to receive a Good Faith Estimate explaining how much your medical care will cost, including the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
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.
Make sure your health care provider gives you a Good Faith Estimate in writing at least one 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 services.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Cost of services do not change based on the location of the service, our agency may provide services via telehealth or at any of our agency office sites. For a list of sites, please see our agency website at www.mopsohio.com.
This information is required by the Counselor, Social Worker, and Marriage and Family Therapist Board, which regulates the practices of professional counseling, social work, and marriage and family therapy in this state.
Ohio Counselor, Social Worker and Marriage & Family Therapist Board
50 West Broad Street, Suite 1075
Columbus, Ohio 43215-3344