Practice Policies

Contacting Us

The therapist can be reached by calling or texting the main phone number (307) 257-5053, by email, or by client portal. Please allow at least 24 hours for
a response. If the therapist is unavailable and the client is reaching out because of an emergency they are advised to call 911 or the Campbell County Health
Behavioral Health Crisis Line at 307-688-5000 immediately.

Appointments & Cancellations

Clients and/or guardians may schedule or cancel appointments by call, text, email or client portal. A missed appointment or cancellation with fewer than
24 hour notice, will result in a full session fee charged to the credit card on file. This also applies to clients seen at their school, or picked up from their school.
If the therapist has not been notified of the client’s absence from school at the time of the scheduled appointment, this is considered a no-show and the
card on file will be charged the full fee. Two no-shows will result in the cancellation of the client’s remaining scheduled appointments.

Credit Cards

A credit card is required to be kept on file throughout the client’s treatment (even if services are entirely covered by client’s insurance or third party payer).
Payment is expected at the time of service and charged to the credit card the night of the appointment. If at any time there is a balance on the account, the
card on file will be charged for what is owed, unless the client arranges a payment schedule by completing the financial agreement form.

Autopay

Autopay is used to collect payment from the credit card on file. Each day our system will automatically invoice and charge the known (or estimated) cost for
the appointment. In addition, our system automatically communicates with in-network insurances. If there is a discrepancy between what was already
charged and the amount insurance has remitted, the difference will be adjusted in the account accordingly. This may result in a change in the amount
charged after the next appointment.

Good Faith Estimate

A Good Faith Estimate (an estimate of out-of-pocket cost) to all clients before services are obtained (in accordance with The No Surprises Act (H.R. 133),
effective 01/01/2022). Once the client’s diagnosis and plan for treatment is clear, an updated Good Faith Estimate can be provided upon request.

Payment Plans

Clients are welcome to discuss a payment plan with their therapist. Agreements about the client’s financial responsibility will be acknowledged by
completing a Financial Agreement Form.

Insurance Billing

Clients requesting services billed to their health insurance company authorize Free Indeed Counseling Services to release necessary information in order to
submit the insurance claim and obtain payment. This information may include demographics, diagnoses and types of services rendered. In special
situations, this may also include specific documentation such as treatment plans or progress notes in order to justify a claim or authorization for services.
Clients agree to assign benefits to Free Indeed Counseling Services for claims made by the organization. Clients are responsible for all amounts not covered
by their health insurance plan (within the plan’s indicated allowable amount) including deductible, co-pay, or co-insurance amounts, as well as all services
not covered by their health insurance plan (including those which were obtained without prior authorization).

Unpaid Balances

Multiple efforts will be made by Free Indeed Counseling Services to collect on unpaid balances. Payments not received within one month of the date of the
last documented effort made by Free Indeed Counseling Services will result in a 33% of account balance fee, and the total balance will be submitted to a
collection agency.