NEW CLIENT INFORMATION
NEW CLIENT INTAKE FORMS
You can speed up your initial visit by printing our Intake Form before you come in and bring them with you.
Fill them out and bring them with you to your first session so we don’t have to take up session time with paperwork. Be sure to come a few minutes early the first time if you can so we can get the rest of the information we’ll need.
You can read and print a copy of our Policies and Procedures Document which will give you more information about how our office operates.
You will need Adobe Reader.
PAYMENT INFORMATION
Payment for services rendered is expected at the time of your session. If you require special payment arrangements, please make those in advance of your session. We accept Visa, MasterCard, Discover and American Express, but as a small independent business, we appreciate cash or checks due to the high credit card service fees.
There will be a $30 fee for any returned checks.
24-HOUR CANCELLATION/RESCHEDULE POLICY
When you make your initial appointment, you will need to secure your appointment with a credit card. Your card will be “pre-authorized” for the full session fee of $175.00. Except in the case of an actual emergency, if you fail to come for your appointment, or if you cancel or reschedule without 24 hours notice (1 business day), your card will be charged. If you are unable to keep your appointment, feel free to call and reschedule or move it, but do give us 24 hours so we can attempt to fill the spot we held for you.
NOTE: If you are using insurance to pay for your sessions, YOUR INSURANCE COMPANY WILL NOT PAY FOR SESSIONS YOU DO NOT ATTEND. If you fail to come for your appointment your card will be charged for the missed session.
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WHY YOU MAY NOT WANT TO USE YOUR INSURANCE BENEFITS TO PAY FOR YOUR SESSION:
So that you clearly understand the consequences of using insurance, before your insurance company will pay for your session, they will REQUIRE:
- information about your session – therefore you do NOT have 100% confidentiality
- that you MUST be given a MENTAL ILLNESS DIAGNOSIS, which will be a permanent part of your medical records.
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INSURANCE INFORMATION
AIM Counseling Center currently accepts payment from only a few select insurance companies, and in the near future, we will discontinue accepting all insurance due to the low reimbursement rates and the high cost of doing business with them. The other factors in our decision to terminate insurance contracts is the enormous amount of paperwork they require, and the fact that your personal information is not private or confidential when you use insurance to pay for service.
There are many different insurance carriers and many different plans within each company. If we accept your plan, and it pays for the type of service you seek (most do not cover marriage counseling), and you choose to use insurance to pay for your session, there are things that affect how much you have to pay. Some plans require that you pay a “co-pay” of various amounts, and others include a yearly “deductible” amount which must be met before the plan will pay. Unfortunately it is almost impossible to determine exactly what any insurance plan will pay for or cover until we actually receive an EOB (explanation of benefits) long after your session. However, we will do our best to authorize and confirm your plan in advance of your appointment. You may also investigate your status and your plan with your insurance company by calling the 800 number listed on your card.
NOTICE REGARDING AUTHORIZATIONS
If your insurance company requires an authorization number be assigned to you before you are allowed to have your first session, it is your responsibility to contact your insurance company in advance of your appointment time and obtain any authorization information your insurance company may require to pay for your session.
In order to determine if your particular insurance plan has this requirement, again, you can call the 800 number listed on your insurance card. If an authorization number is required, simply request one FOR THE PERSON ACTUALLY BEING SEEN in the appointment, and bring it with you to your first appointment. It is illegal to bill an insurance company for someone who was not actually physically present for the session being billed.
If your insurance company requires an authorization number and you do not get one, generally, they will not allow us to “back date” billing. In the event an authorization number is needed you do not get one, you will be financially responsible for the normal session fee of up to $175.00 per visit.
Please be advised that insurance companies are very difficult to work with, and often have very strict rules about authorizations.