Out of Network

• Please note that I do not bill insurance directly. If you have a PPO insurance plan, you may have an out-of-network (OON) benefit that covers behavioral health services. You will need to contact your insurance company directly to determine your OON benefits, along with how to file a claim. I will provide you with an insurance-ready receipt (“Superbill”), which you are welcome to submit to your insurance company to request reimbursement for services received. Alternatively, you may use a flexible spending account (FSA) or a health savings account (HSA) to pay for your appointment fees, as individual therapy is a qualified medical expense.

• Relationship therapy is not a covered medical expense unless one partner carries a mental health diagnosis that the insurance company deems significant enough to justify treatment. In this case, the therapy is centered around how the one partner’s mental health diagnosis impacts the relationship. Most of the relationship partners seen by Azalea Psychological do not fit this description and instead are looking to improve their relationship (communication, intimacy, conflict) to increase relationship satisfaction and functioning. This will be discussed in more depth during phone consultations for relationship therapy.

• Clients can opt out of using their health insurance for any reason and “self-pay” for services. Some individuals who anticipate legal proceedings in which mental health records may be subpoenaed, pursuing employment involving classified, high-level government work or the Peace Corps, or seeking military careers may decide to self-pay instead of using insurance.

No-Show/Late Cancellation Policy

Failure to show (“no-show”) to your appointment or cancelling your appointment within 48 hours of the appointment day/time will result in a flat-rate fee of $120. This is not inclusive of emergency situations.

Good Faith Estimate (GFE)

As of January 2022, you have the right to receive a “Good Faith Estimate” (GFE) explaining how much your medical care will cost. Under a new law, healthcare providers are required to provide patients who either do not have or who are not using health insurance an estimate of the bill for medical items and services. This estimate should be received in writing prior to your medical service or appointment. For more information, please visit https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/no-surprises-act.

Administrative Tasks Policy

Document preparation, letters, clinically-related phone calls, and other administrative tasks that exceed 15 minutes will be billed at a fraction of my hourly rate for individual therapy, in 15-minute increments. For example, the fee is $87.50 for 16 to 30 minutes, $131.25 for 31 to 45 minutes, $175 for 46 to 60 minutes, etc. I will inform you about whether an administrative task is expected to take longer than 15 minutes prior to engaging in the task/action, so you are aware of any fees incurred.  

Accepted Methods of Payment

• Azalea Psychological uses a HIPAA-compliant, secure payment platform called Ivy Pay.

• Client payment card information is stored securely with Ivy Pay and Azalea Psychological will not have access to this information at any time.

• During the intake/initial appointment, I will ask for a mobile phone number, which will be entered into Ivy Pay’s secure app along with the charge for the session fee.

• Ivy Pay will then text a secure link, which leads to a page for clients to enter their payment card information and approve the first charge.

• For all future appointments, Ivy Pay will be used to charge the stored payment card. Clients can update their payment card information at any time.

• Ivy Pay accepts credit, debit, Health Savings Account (HSA), and Flexible Savings Account (FSA) cards.

• Ivy Pay’s Terms of Use can be found here. If you have any questions or concerns about this payment method, please reach out to discuss this.

• Payment is due when services are rendered.