For your convenience, you may click the link at the bottom oft his page to download the paperwork required for your first session.
New Client Paperwork:
Each client attending therapy must read, complete and print off one packet of forms each, and bring to initial session.
Read and keep pages 1-6 for your records. You can complete the form directly from your computer and then print it,
or print it out first and hand write the form.
All clients attending therapy must bring pages 7-11 completed to the initial session.
Otherwise, they may complete it in the office, which may cut into session time.
To Parents of Minor Children:
Please complete your own set of paperwork, in addition to completing and signing children's forms in designated areas.
If child is capable, please have him/her complete as much of his/her own paperwork as possible.
REMINDER: If you are seeking therapy for a child, the custodial parent(s)/guardian(s) must attend the initial session without the child present. Please do not bring your child to the initial appointment. Therapists at MFTS may request contact with non-participating legal guardian(s) of child at any time during treatment, and may also request participation in treatment by these guardian(s), regardless of custodial status.
Appointments may be rescheduled if a child under 13 years of age is brought to an appointment that is not specifically set up for them. Please remember that any time we are working with a minor child, we may require documentation of custodial rights prior to seeing the child for therapy.
If a given appointment is not specifically set up for your child/children, we ask that you do not bring them to our office. We cannot be responsible for their well-being, and minors under 13 cannot be left in the waiting room unattended by their parent/guardian.
OUR POLICY ON HEALTH INSURANCE:
Insurance companies do not pay for missed sessions. We require 48 hours' notice to cancel or change appointments for not-emergent reasons. Clients are charged the entire session fee if required notice is not provided, regardless of insurance benefits or any other discounts.
OPTION 1: We file claims (HealthGram Insurance ONLY)
As a courtesy to our clients, MFTS can file insurance claims on your behalf with Health Gram, as wear e in-network with this insurance group. While we are happy to assist you with the insurance claims-filing process whenever possible, there is never a guarantee of payments. Your insurance coverage is a contract between you and your insurance company, and your account balance with MFTS is always your responsibility, regardless of your insurance benefits.
To verify your benefits prior to your initial appointment, MFTS must have your member ID number or a copy of the front and back side of your insurance card, as well as the insured's date of birth, no later than 2 business days before your initial appointment. You may FAX this to: 828.328.4673, mail it to our office, or hand-deliver it to us. You may also call our office line and give us this information verbally. We cannot honor any co-pays or coinsurances unless we have received your member number or card within the appropriate timeframe. If you fail to provide your member number or insurance card, you will be responsible to pay our full fee, out of pocket. We will credit your account or reimburse you any difference later, once we verify your benefits.
Please see information below regarding how we handle other insurance companies such as Blue Cross Blue Shield, Cigna, United Health Care, etc.
OPTION 2: You File Claims
If you have insurance with a company other than HealhGram such as Blue Cross Blue Shield, Cigna, United Health Care, etc., you may be eligible to utilize "out-of-network benefits." Many of our clients take advantage of this benefit offered through their insurance company, which allows them to see a therapist with our practice and receive reimbursement directly from their insurance company. MFTS encourages you to contact your insurance carrier and insist upon reasonable coverage to support your mental health needs! We will be happy to discuss any concerns you have, or answer questions for you, regarding filing your own health insurance claims.
A link at the bottom of the page entitled "Insurance 101" will take you to a document that provides
detailed information for investigating your "Out of Network" options.
Marriage and Family Therapy Services encourages clients with out of network benefits to utilize them. You do NOT have to stay within your insurance network if your coverage allows you to go out of network. It does require a little extra work and investment up front, but if you will ultimately be reimbursed by your insurance company, and you can get the benefit of utilizing the skill of true experts in the profession of Marriage and Family Therapy, we believe this added work becomes truly worth it.