Financial Policy

The staff at Mind At Ease, LLC are committed to providing caring and professional mental health care to all of our clients. As part of the delivery of mental health services, we have established a financial policy that provides payment policies and options to all consumers. The financial policy of the practice is designed to clarify the payment policies as determined by the management of the practice.

The Person Responsible for Payment of Account is required to sign the Acknowledgment Statement on the Demographic Form stating that this policy has been received and reviewed. Your insurance policy, if any, is a contract between you and the insurance company; we are not part of the contract with you and your insurance company.

As a service to you, the practice will bill Blue Cross/ Blue Shield Of Illinois PPO insurance company, but cannot guarantee such benefits or the amounts covered, and is not responsible for the collection of such payments. In some cases insurance companies or other third-party payers may consider certain services as not reasonable or necessary or may determine that services are not covered. In such cases the Person Responsible for Payment of Account is responsible for payment of these services. We charge our clients the usual and customary rates for the area. Clients are responsible for payments regardless of any insurance company’s arbitrary determination of usual and customary rates.

The Person Responsible for Payment (as noted in the Payment Contract for Services) will be financially responsible for payment of such services. Payments not received after 120 days are subject to collections. A 1% per month interest rate is charged for accounts over 60 days.

Insurance deductibles and co-payments are due at the time of service. Although it is possible that mental health coverage deductible amounts may have been met elsewhere (e.g., if there were previous visits to another mental health provider since January of the current year that were prior to the first session at the practice), this amount will be collected by the practice until the deductible payment is verified to the practice by the insurance company or third-party provider.

All Out-Of-Network insurance benefits will be assigned to the client (by insurance company or third-party provider) provided that the Person Responsible for Payment of Account pays the entire balance each session.

Clients are responsible for payments at the time of services. The adult accompanying a minor (or guardian of the minor) is responsible for payments for the child at the time of service. Unaccompanied minors will be denied non-emergency service unless charges have been preauthorized to payment at the time of service.

Missed appointments or cancellations less than 24 hours prior to the appointment are charged $60 as noted in the Payment Contract for Services.

Payment methods include credit card, check or cash.

Questions regarding the financial policies can be answered by Nirali Dalia (mindateasellc@gmail.com).