Fees, Billing Practices, & Cancellations / Missed Appointment Policies

STANDARD FEES 

Our fees for intake sessions and services are outlined in the fee schedule and vary by service and provider. The fee schedule can be found on your patient portal and on our website here. If we determine at intake that we are not a good fit for your needs, this does not waive the fee for the intake services that were provided.

Group sessions billed according to the specific group policy. This may include billing monthly rather than following service and often have different cancellation/missed appointment policies. If you are entering a group, please be sure you understand the billing procedures for that specific group before entering.

ANCILLARY and LEGAL FEES

If you and your provider meet for more than the usual time, or if your case requires more out of session contact or case management than is typical, you may be charged accordingly. Examples of this type of service include report writing, telephone conversations (with you or with other people or professionals associated with your case) lasting longer than 15 minutes, attendance at meetings with other professionals you have authorized, preparation of treatment summaries, and time spent performing any other service you may request. Ancillary rates are included in the fee schedule.

If you become involved in legal proceedings that require your provider’s participation, you will be expected to pay for any professional time your provider spends on your legal matter, even if the request comes from another party. This includes ancillary services related to the legal concern, including but not limited to travel, preparation of documents or testimony, needed legal consultation, and all time spent in court (whether or not testifying at that time). If you have reason to believe that you do or will need such services, we suggest you speak with an administrative staff member or your clinician to determine whether the TAP Clinic is the best and most cost-effective option to obtain this support. Please note that our fees for legal proceedings are substantially higher than general care and can be found in our fee schedule. 

ASSESSMENT & TESTING FEES

Assessment fees include time spent in face to face interactions (e.g., intakes, testing) as well as the assessor’s time for scoring, interpreting, and writing up your assessment results. The hourly fees for testing services are outlined in the fee schedule. Following your initial testing intake session, you will be given an estimation of the expected assessment time and fees and will have the opportunity to decline part or all additional testing. Doing so may result in a less comprehensive, accurate, or effective assessment result. If you decline further testing services at that time, you will still be expected to pay for the initial testing assessment session for services already rendered. Final costs will be determined after all scoring and interpretation has been completed, and final payment for all assessment services is due at the time of the feedback session.

LATE CANCELLATIONS AND MISSED APPOINTMENT POLICIES

Cancellation/rescheduling of individual, couples, or family services must be done 24 business hours in advance or the full fee will be charged for the appointment. Please note that appointments scheduled on Mondays require cancellation on or before the previous Friday in order to comply with the 24 business hour policy. You should not consider your appointment canceled until you have received confirmation from the office manager or your provider that s/he has received your message. If you miss, are late to, or leave early from a billed service, you will be responsible for the entire charge of the reserved time, unless an alternative arrangement was agreed upon in advance with your provider. Please note that insurance typically does not reimburse for missed or late services.

Cancellation policies for groups often differ from the above and should be discussed with your group provider. Unlike individual therapy appointments, where a provider can offer another patient your canceled session with enough notice, groups do not allow for non-established group members to join in a cancellation. Therefore, most groups bill for the group session whether or not you attended, in recognition that you have reserved this group spot whether or not you use it that particular week. Cancellation fees are therefore charged whether or not they are made within 24 business hours.

BILLING AND PAYMENTS

You will be expected to pay for each session at the time of service unless you and your provider agree otherwise. We accept cash, check, and credit cards. Checks are made payable to TAP Clinic, PLLC. If your account has not been paid for more than 60 days and arrangements for payment have not been agreed upon, we reserve the right to discontinue treatment until the balance has been paid, or we may use legal means to secure the payment. This may involve hiring a collection agency or going through small claims court. If such legal action is necessary, its costs will be included in the claim. As a courtesy, you may place your credit, debit, and/or FSA/HSA card on file through the patient portal to process fees associated with your care. Please be aware that your card may be charged on a different date than your service; in most circumstances charges are run weekly. Our administrative staff are not able to access the full credit card information, which means we are unable to update card information for you; should you need to update or change your credit card for any reason, you will need to do so through your patient portal.

Refunds. As a clinic policy, we do not provide refunds for services already rendered. As is industry policy, you are billed based on the amount of time you were in your appointment, not whether you agreed with the service results, recommendations, or effectiveness. We also do not provide discounts for services that you attended late or left early, unless previously agreed upon with your provider. Billing errors

where you were improperly billed for a service that did not occur (with the exception of late cancellations or no-shows) or at the wrong rate, will of course be refunded.

Fee disputes. If you believe a charge has been run incorrectly, please contact our administrative staff, who will assess the concern and correct any errors, including issuing a refund if appropriate. Disputing a charge directly with TAP will not incur any additional charges; however, if you dispute a charge through your credit card company or bank, you will be assessed a $25 “chargeback fee” (similar to a bounced check fee).

By placing any card on file through the Valant system, you consent to the following:

1) Your (or your guarantor’s) debit or credit card can be billed for the following purposes: full payment of attended services for myself or for a family member, late cancellation fees or no-show fees in accordance with individual or group therapy billing policies, and agreed upon ancillary services (e.g., report writing or review of charts).

2) If you dispute a charge through the Valant system, you permit the TAP Clinic to provide any relevant information to validate a charge we believe to be correct without obtaining further permission or consent from you. This may include your name, contact information, date of service, and a general description of the service (e.g., psychotherapy session, psychiatry session). No clinical information will be provided and only the least amount of information needed to resolve the dispute will be given.

Insurance Reimbursement

OUT-OF-NETWORK POLICIES

All TAP Clinic providers are out of network for all insurance policies. If you have a health insurance policy, it will usually provide some coverage for mental health treatment, though it may not for out of network or non-participating providers. We can provide you with invoices for services rendered that you may file with your insurance company to receive any out of network benefits you may have. If another party (e.g., a parent or family member) is paying for services rendered, we will provide that person (also known as a “guarantor”) with an insurance superbill upon request. A superbill includes the dates of service, type of service rendered (e.g., individual or group therapy), your diagnostic code, and the charges associated with the service.

Please note that we do not submit forms directly to insurance companies, nor do we accept payment directly from insurance companies. You (not your insurance company) are responsible for full payment of our fees, and you are responsible for finding out exactly what mental health services your insurance policy covers. You should carefully read the section in your insurance coverage booklet that describes mental health services to determine insurance benefits such as types of covered services, deductibles, percent of coverage for out of network providers, and length of treatment covered. If you have questions about coverage, please call your plan administrator.

Please be aware that you will be unable to submit for reimbursement to either Medicaid or Medicare, as the TAP clinic does not participate in either program. If you have Medicare as a primary or secondary insurance, you will also be asked to sign an opt out form. Please note that Dr. Ritschel cannot see or supervise cases for patients who have Medicaid or Medicare as primary or secondary insurance.   

Please note that insurance companies do not always reimburse for multiple sessions on the same day (e.g., if you attend an individual and a group therapy session), so be sure to ask your insurance company about this when you verify your benefits. You should also be aware that most insurance companies require that you provide them with your clinical diagnosis. Sometimes we have to provide additional clinical information, such as treatment plans, progress notes or summaries, or copies of the entire record (in rare cases). This information will become part of the insurance company files. Though all insurance companies claim to keep such information confidential, we have no control over what they do with it once it is in their hands. Your signature authorizes the TAP Clinic to speak with your insurance company if needed and to release such information as requested. We will do our best to keep that information limited to the minimum necessary. Commonly used CPT codes are available on our website or can be discussed with your intake clinician.

Minor Patient Addendum

PAYMENT AND INSURANCE CONSIDERATIONS FOR FAMILIES

We fully understand that payment for medical services can be a tricky issue for separated or divorced parents. We ask parents in this situation to be aware of the following points:

1. We can provide superbills to both parents for their records, but only one parent may submit for insurance reimbursement.
2. Payment issues or disputes need to be resolved between caregivers and will not be mediated by the TAP Clinic Admin Staff or your clinical provider(s). Payment for services rendered is due in a timely fashion and the Guarantor listed on file will be the party for which TAP will ultimately expect payment should no resolution among parents be resolved.

Multi-Patient Addendum

BILLING

Codes: Multi-patient sessions (e.g., parent training, couples, or family) may or may not be reimbursed by your insurance company. Insurance companies will want to know the name of the person(s) on the chart, the diagnostic code, and the billing code (also called a CPT code). There are several ways to appropriately and ethically code for multi-patient sessions, but there are also several important aspects to this decision that warrant careful consideration. Please speak directly with your provider to understand what options may be available in your particular case and the ramifications of this.

Insurance: Regardless of how many names are listed on the chart, you can only submit for reimbursement under one person’s policy (e.g., either Patient A or Patient B could submit claims). Some insurance companies have denied claims that list more than one name on the policy. We recommend that you check with your insurance carrier to find out what the implication of listing more than one person is on reimbursement.

Diagnosis: Depending on which code is used, we may use one person's diagnosis for the chart. An individual DX will only be used when the TAP Clinic is able to verify the current accuracy of the DX by consulting with an individual provider treating this patient or a separate assessment of this patient by a TAP provider. If an individual has their own DX (MDD, OCD, PTSD), but it is not the focus of treatment, it cannot be listed as the diagnostic code for these sessions. Other times it may be more appropriate for us to use a Z code (e.g., parent child relational problem; Relational distress with spouse or intimate partner). Some insurance companies may not reimburse for a Z code.