CREDIT, COLLECTIONS, & FINANCIAL ASSISTANCE POLICIES

Mission Statement

PsychConcierge is committed to providing accessible, high-quality mental health and substance abuse services through our concierge model. At PsychConcierge, your mental health, emotional well-being, and personal growth are our highest priorities. We deliver deeply personalized care that combines clinical excellence with authentic empathy and deliberate attention to detail. Our direct-pay model allows us to focus entirely on patient care without the constraints of insurance limitations, ensuring that we can devote meaningful time not only during sessions but in the critical intersession work of refining, researching, and customizing your treatment plan.

Purpose

To establish clear, transparent payment procedures and financial assistance options that support our mission while maintaining the sustainability of our concierge practice. This policy ensures compliance with applicable regulations while providing flexible access to mental healthcare services.

CONCIERGE SERVICE MODEL

Service Structure

PsychConcierge operates as a fully integrated teleheath practice offering a direct-pay concierge model that provides:

• Comprehensive mental health evaluations through our detailed intake process

• Psychopharmacological services delivered by licensed and board-certified clinicians

• Psychotherapeutic services provided by certified and licensed mental health professionals

• Integrated medication management with tailored psychotherapy drawing from your unique needs, values, and life context

• Supervised clinical training services delivered by clinical trainees under direct supervision of fully licensed and board-certified providers

• Flexible virtual scheduling with reserved time slots based on upfront payment

• Direct access to clinicians between sessions for care coordination

Payment Philosophy

Our concierge model was developed in response to the limitations of traditional insurance-based mental healthcare, where reimbursement rates remain inconsistent and inadequate, and critical intersession clinical work such as case conceptualization, coordination, and treatment planning goes uncompensated. Our direct-pay approach requires upfront payment to reserve time slots, ensuring dedicated, uninterrupted care focused on patient outcomes rather than insurance restrictions. This model allows for:

• Unhurried, thoughtful care that prioritizes depth over throughput

• Comprehensive intersession work including treatment planning and care coordination

• Flexible session lengths based on clinical need rather than insurance limitations

• Immediate access to care without prior authorization delays

• Enhanced privacy with no insurance reporting requirements

• Growth measured by clinical outcomes, not case volume

PAYMENT PROCEDURES

Service Reservation (Upfront Payment Requirements)

• Prospective patients complete a Member Application to explore whether PsychConcierge is the right fit for their mental health journey

• All appointments require payment in advance to secure time slots

• Payment confirms appointment reservation and practitioner availability

• Payments accepted via credit card or debit card only

• Payment processing available through secure online portal

Payment Timing

• Payment due at time of appointment scheduling

• Multi-session packages require full payment at time of purchase

• No services rendered without confirmed payment

PRICING STRUCTURE

Individual Session Rates

• Initial Evaluation [Intake]: $500 (80 minutes)

• Psychotherapy Session: $400 (50 minutes)

• Psychopharmacology Session: $300 (25 minutes)

• Rates reviewed annually and posted on PsychConcierge.com with 30-day advance notice of changes

MULTI-SESSION PACKAGE DISCOUNTS

Psychotherapy Packages

Psychopharmacology Packages

Multi-Session Package Rules and Regulations

• Packages must be used within 24 months of purchase date

• Package sessions are non-transferable and operate under the no-refund credit system

FINANCIAL ASSISTANCE AND ACCESSIBILITY

Sliding Scale Services Through Clinical Training Program

PsychConcierge ensures accessibility for individuals unable to afford standard concierge rates through our clinical training program

Program Structure

• Services provided by clinical trainees under direct supervision of board-certified providers

• Sliding scale fee structure based on household income and Federal Poverty Guidelines

• Same quality standards maintained through comprehensive supervision

• All clinical trainees are advanced practitioners in accredited training programs

Eligibility Criteria

• Household income below 400% of Federal Poverty Guidelines (current guidelines available at https://aspe.hhs.gov/poverty-guidelines)

• Completion of financial assistance application with income verification

• Clinical appropriateness for training program participation

• Commitment to treatment plan and appointment attendance

Confidential Application Process: PsychConcierge supports confidential application pathways for financial assistance for individuals impacted by intimate partner violence, minors seeking independent care, or other special circumstances. Please contact us directly to discuss safe and private options that protect your confidentiality and safety.

Required Documentation:

• Completed financial assistance application

• Proof of household income (tax returns, pay stubs, benefit statements)

• Verification of household size

• Bank statements showing liquid assets

• Additional documentation for special circumstances as needed

SLIDING SCALE FEE DETERMINATION

Income-Based Fee Structure

• 0-100% of Federal Poverty Level: Services at 90% discount

• 101-200% of Federal Poverty Level: Services at 70% discount

• 201-300% of Federal Poverty Level: Services at 50% discount

• 301-400% of Federal Poverty Level: Services at 30% discount

Asset Considerations

• Liquid assets exceeding $5,000 may affect sliding scale eligibility

• Primary residence and retirement accounts excluded from asset calculations

• Special circumstances considered on individual basis

Financial Assistance Appeals Process

• Appeals for Financial Aid Decisions: Patients may request a second review of financial assistance decisions. Appeals should be submitted in writing within 30 days of the initial decision and include any additional supporting documentation. Appeals are reviewed by a senior clinician or administrator and responded to within 10 business days. The appeals process ensures fair and thorough consideration of individual circumstances that may not have been fully addressed in the initial application review.

GOOD FAITH ESTIMATES AND TRANSPARENCY

No Surprises Act Compliance

In accordance with federal requirements, PsychConcierge provides good faith estimates to all patients. See Patient Rights for more details.

Estimate Requirements

• Written good faith estimates provided before services for all patients

• Estimates based on published fee schedule (Intake: $500, Psychotherapy: $400, Psychopharmacology: $300)

• Package pricing and discount information provided when applicable

• Clear description of services to be provided including session duration

• Provider information and contact details

• Disclaimer regarding patient rights to dispute resolution

Estimate Accuracy

• Estimates based on current fee schedules and expected services

• Updates provided if treatment plans change significantly

• Patient notification of cost changes exceeding $400 from original estimate

COST TRANSPARENCY

Published Fee Schedules

• Current individual session rates posted on website and available upon request:

  • Intake Evaluation: $500 (80 minutes), with referral discounts available

  • Psychotherapy: $400 (50 minutes)

  • Psychopharmacology: $300 (25 minutes)

• Package pricing clearly displayed with specific discount percentages (6.25%-25% savings)

• Sliding scale rate structure published for training program services

• No hidden fees or surprise charges

Pre-Service Communication

• All costs discussed and confirmed before delivery of service

• Payment options and package benefits explained during consultation

• Written estimates provided for treatment plans exceeding single sessions

CANCELLATION REQUIREMENTS AND REFUND POLICY

Advance Notice

• 48-hour advance notice required for appointment cancellations to retain session credit

• Cancellations with less than 48 hours notice result in session forfeiture

• Emergency circumstances considered on case-by-case basis for credit retention

Package Session Cancellations

• Package sessions cancelled with 48-hour advance notice retain session credit

• Late cancellation or no-show results in session forfeiture

• Session credits remain valid within the 24-month package validity period

• Rescheduling accommodated using available session credits

NO REFUND POLICY AND CREDIT SYSTEM

No Refund Policy: PsychConcierge operates under a strict no-refund policy. All payments made to PsychConcierge are final and non-refundable. Instead of refunds, all qualifying payments are retained as account credits for future session use.

Credit System for Qualifying Circumstances

Appointment Cancellations:

• Appointments cancelled 48 hours or more in advance retain full session credit for future use

• Session credits remain valid for 24 months from original purchase date

• Credits may be applied to any future session type (psychotherapy or psychopharmacology)

Overpayment Corrections:

• In the rare event of billing errors or overpayments, excess funds become account credits

• Credits are applied automatically to future sessions

• Patients may request account reviews at any time to verify accuracy of charges

• No cash refunds issued for overpayments

Practitioner-Initiated Changes:

• Sessions cancelled by practitioner due to emergency or illness result in session credit retention

• Credits remain available for rescheduling within the 24-month validity period

• No monetary refunds provided under any practitioner-initiated circumstances

Single Exception - Death of Patient:

• In the event of patient death, unused session credits may be returned to the patient's estate or designated beneficiaries

• Estate refund requests require proper documentation including death certificate and estate authorization

• Refund processing for estate requests completed within 30 business days of receipt of required documentation

• This exception applies only to unused prepaid session credits, not individual completed sessions

Non-Refundable Under All Circumstances:

• Completed session payments

• Administrative fees for payment processing

• Cancellations with less than 48 hours notice

• No-show appointments

• Package sessions used within the 24-month validity period

OUTSTANDING BALANCE MANAGEMENT

Collection Procedures

While our upfront payment model minimizes outstanding balances, collection procedures address the following aspects.

Limited Collection Scenarios:

• Disputed charges requiring resolution

• Package session overages

• Supplemental service charges

• Administrative fees

Collection Timeline and Notice Requirements:

Structured Notice Process — We send three formal notices over 90 days before any escalation to external collection consideration.

• First Notice — Sent within 15 days of charge with full account details

• Second Notice — Sent at 30 days with payment options and financial assistance information

• Final Notice — Sent at 60 days with clear statement of potential collection escalation

• Review Period — 30-day grace period after final notice before external collection consideration

This multi-step approach ensures patients receive adequate notice and opportunity to address outstanding balances while maintaining transparency in our collection process.

WRITE-OFF AUTHORITY

Administrative Write-Offs:

• Balances under $50: Practice Manager authority

• Balances $50-$500: Clinical Director authority

• Balances over $500: Owner/Medical Director authority

PATIENT RIGHTS AND PROTECTIONS

Privacy and Confidentiality

Our direct-pay model enhances patient privacy by:

• Eliminating insurance company reporting requirements

• Maintaining complete confidentiality of treatment records

• Providing patient control over information sharing

• Ensuring HIPAA compliance without third-party disclosure

BILLING DISPUTE RESOLUTION

Internal Dispute Process:

• Written dispute submissions reviewed within 10 business days

• Patient consultation scheduled to discuss billing concerns

• Resolution documentation provided in writing

• Appeal process available through practice management

External Dispute Options:

• Patient-provider dispute resolution available per No Surprises Act

• State licensing board complaint process information provided

• Professional liability insurance information available upon request

QUALITY ASSURANCE AND COMPLIANCE

Regular Review:

• Annual policy review and updates

• Fee schedule evaluation and adjustment

• Sliding scale criteria assessment based on Federal Poverty Guidelines

• Patient feedback integration into policy improvements

Staff Training:

• Comprehensive training on payment procedures and financial assistance

• Regular updates on regulatory compliance requirements

• Patient communication and sensitivity training

• HIPAA and privacy protection education

REGULATORY COMPLIANCE

This policy ensures compliance with:

• No Surprises Act Good Faith Estimate Requirements

• Fair Debt Collection Practices Act

• HIPAA privacy and security requirements

• State licensing and professional standards

• Federal and state consumer protection laws

This policy is effective as of Sunday, August 3, 2025 and supersedes all previous versions. Policy revisions require approval by the PsychConcierge Clinical Director and Practice Management.

REFERENCES

American Psychiatric Association. (n.d.). No surprises act implementation. https://www.psychiatry.org/psychiatrists/practice/practice-management/no-surprises-act-implementation

Centers for Medicare & Medicaid Services. (n.d.). No surprises: Understand your rights against surprise medical bills. https://www.cms.gov/newsroom/fact-sheets/no-surprises-understand-your-rights-against-surprise-medical-bills

Consumer Financial Protection Bureau. (n.d.). Know your rights and protections when it comes to medical bills and collections. CFPB Blog. https://www.consumerfinance.gov/about-us/blog/know-your-rights-and-protections-when-it-comes-to-medical-bills-and-collections/

Experian Health. (2024, August 21). 5 patient-friendly billing practices to speed up collections. Healthcare Blog. https://www.experian.com/blogs/healthcare/5-patient-friendly-billing-practices-to-speed-up-collections/

U.S. Department of Labor. (n.d.). No surprises act. https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/no-surprises-act