Financial Agreements & Terms
Billing and Payments:
You will be expected to pay for each session at the time of the appointment unless we have agreed to other arrangements. In the case of health insurance, you will be expected to provide any deductible or co-payments prior to our session meetings. Keep in mind that it is you (not your insurance company) that is responsible for the full payment of fees. Therefore, it is very important that you find out exactly what mental health services your insurance policy covers.
Rainbow Behavioral Health offers a sliding fee for persons whose household income falls below certain levels. If you do not have health insurance, or you have a high deductible health insurance plan, please speak with your therapist. We will not refuse service to anyone who cannot afford to pay for services.
Copays & Co-insurance:
My signature below indicates that I understand and agree to pay for any copays at the beginning of my session on the date it is provided. If I am utilizing health plan benefits, I understand I am responsible for any amount my insurance does not cover.
Cancellation, No Show, or Late Arrival:
In general, all clients must provide the therapist a minimum of 24 hours notice in the event of a cancellation. Clients will be charged for appointments that are not canceled at least 24 hours in advance and for all no-shows. Insurance companies do not pay for missed appointments, therefore, you will be responsible for the full amount charged. Clients arriving late will not be provided an extension of time beyond what they were scheduled so as not to disrupt other client appointments. No reduction in fees will result from shortened sessions due to a client’s late arrival. These terms may not be applicable to you if are receiving coverage through the MN Health Care Programs (MHCP).
Account Balance Maximum:
Whenever a client’s account reaches an outstanding balance of $500 and no payments have been made or received toward the account, additional counseling services may be suspended. Services will remain suspended until the client begins making a payment toward their account.