HIPAA and PHI Policy
COUNSELING FEES AND PAYMENT POLICIES
The services provided by the Friends Counseling Center are performed by master’s level counselors, most of whom are licensed by the State of Indiana or certified nationally by the National Board for Certified Counselors. A standard session time is a 53 minute hour.
INSURANCE: If you have insurance that includes Mental Health Benefits, the initial session will be billed at $200 and each session thereafter will be billed at $150. You will be responsible for the remaining amount not covered under your Mental Health Benefits. The insurance benefits quoted by your insurance company and/or FCC are not a guarantee of payment. Please note that benefits can change periodically and may affect the amount that your insurance company will pay. The final confirmation of your benefits and copay will appear on the Explanation of Benefits you receive from the insurance company.
SLIDING SCALE: If clients do not have insurance or choose to not bill services through insurance, we offer sliding scale fees based on the client's annual household income. An additional $20 will be billed for the initial session and yearly intakes.
Proof of income must be provided to determine and set the session fee (i.e. a current tax return or the three most recent pay stubs). Clients should report any changes to income and provide supporting documentation. Clients must provide their proof of income via mail, email, fax , or in person prior to or at their first appointment. If proof of income is not received by the first appointment, clients will be charged a $75 fee for the initial session. Clients will not be able to re-schedule until proof of income is provided.
Annual Income Fee Annual Income Fee
Under $20,000 $55 $60,001-70,000 $90
$20,001-25,000 $60 $70,001-80,000 $95
$25,001-30,000 $65 $80,001-90,000 $105
$30,001-35,000 $70 $90,001-100,000 $115
$35,001-40,000 $75 $100,001-110,000 $125
$40,001-50,000 $80 $110,001-120,000 $135
$50,001-60,000 $85 Over $120,000 $145
PAYMENT: Payment for counseling is due at the time of your counseling session. No cash will be accepted at the Satellite offices (Huntington, Logansport, Marion, North Manchester, Tipton). Checks should be made payable to Friends Counseling Center (FCC). We also accept Visa, MasterCard, and Discover over the phone or with a credit card authorization on file. If clients miss two payments, we will not be able to schedule further appointments until a payment has been made or a payment plan is arranged with our financial department. Checks returned for non-sufficient funds are charged $25.
SESSIONS and CANCELLATIONS: It is very important to let us know at least 24 hours in advance if an unexpected conflict arises with your appointment time. If you have three consecutive late cancellations or no shows in a three month span, clients will not be able to schedule more than one appointment at a time. Clients will be charged a fee of $20 for late cancellations.
ADDITIONAL CHARGES:
COURT FEES: Friends Counseling Center exists to work with the needs of the client. We do not exist to be witnesses in court cases or determine custody arrangements of children. However, we realize that there may be times that it is the best interest of the client to go to court. The charge is $175/hr port to port with a minimum of one hour. After one hour, it is billed in 30 minute increments. A $350 retainer fee is required.
REPORT WRITING: When a report is requested the client will be billed $75 (These fees are not billable to insurance or Medicaid).
REQUEST FOR RECORDS: Clients may request a copy of their medical records with proper consent. There is a $20 processing fee for this request.
3565 S. State Road 13, Wabash, IN 46992 | 260.563.8453 | 260.569.0335 FAX
office@wabashfriends.org | www.wabashfriendscounseling.com
Wabash | Huntington | Logansport | Marion | North Manchester | Tipton
office@wabashfriends.org | www.wabashfriendscounseling.com
Wabash | Huntington | Logansport | Marion | North Manchester | Tipton
