FINANCIAL POLICIES

 
FEES AND PAYMENTS
  

Vibert Psychiatric Solutions, LLC does file for insurance reimbursement on certain services. All other services are paid by the patient at the time of service. You may pay cash, credit card, HSA card, or Flexible Spending Card, or check. 
  
 As the patient, it is in your best interest to know and understand your insurance plan benefits. It is important that you know your benefits prior to visit. Regardless of your individual insurance coverage or type, as the person seeking medical treatment you are ultimately responsible for all charges.
  
Please know that we are here to help you if you have any questions. We are happy to help you learn how to file your own claim using the superbill we provide.
  
 All outstanding balances must be paid in full prior to next office visit or receiving supplements.
  
MISSED APPOINTMENT FEE

 A $50 missed appointment fee will be charged for cancellations made less than 24 hours in advance or for no-shows. Please provide at least 24 hours' notice if you need to cancel your new patient or initial visit, as well as for any follow-up or routine appointments.

RETURNED CHECK - There is a $20.00 fee for any check returned by the bank.
  
PAST DUE ACCOUNTS

If your account becomes past due, we will take necessary steps to collect this debt. If unable to collect payment, termination of the provider-client relationship will occur within 60 days following non-payment. At the time of your initial office visit a copy of your credit card will be taken. 
  
SPECIAL LETTERS, FORMS, and DOCUMENTS

 Completing special insurance forms, workplace documentation, writing letters of medical necessity, etc. require significant provider time and will be charged an administrative fee of $30 per document/letter. Fees must be paid in advance. Some documentation may require extensive time / complexity and may justify a higher fee. If so, this fee will be disclosed to you prior to preparing the documents. 
 

CREDIT CARD AUTHORIZATION
 

I authorize Vibert Psychiatric Solutions, LLC to maintain my credit card number in the electronic health record and to use it to process payment for services rendered or supplements or other items purchased by me.
 
I authorize Vibert Psychiatric Solutions, LLC to process the credit card on file for any balance due on my account past 30 days and for any payments authorized by me.
 
I understand that a receipt superbill and receipt showing what was paid for will be sent to me within 30 days of each visit. I know that I am responsible for letting the clinic know if anything has changed concerning my credit card information.

MEDICATION REFILL POLICY

A one-time courtesy refill is available for non-controlled medications within 30 days of the last prescription. This courtesy refill does not apply to controlled substances. For controlled substances, an in-person appointment is required for refills. Refill requests must be made during regular office hours and typically require 24-48 hours for processing. Please request refills in advance to avoid running out of medication. We do not provide refills for lost or stolen prescriptions. Requests for refills made after hours or on weekends will be processed the following business day.

Please be advised:
We do not prescribe stimulants for the treatment of ADHD.