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PAYMENT

 

Rates 

$275 Initial Evaluation (50-55 minutes)

$250 per 50 minute Therapy session

$350 per 50 minute Couples session

$200 (per person) for 90 minute Group session


**Payment is due at the time of service.**

 

$400 per Bariatric Pre-Surgical Psychological Evaluation (typically 2 hours to complete and includes a full written comprehensive clinical report for the referring surgeon).

*Please note: Dr. Bauchman cannot accept all insurance plans for the pre-surgical evaluation as every insurance carrier has different requirements. We will gladly assist you in obtaining out-of network benefits by providing you with a receipt and faxing your evaluation results to your insurance carrier (with your permission).

 

Payment 
Cash, check, and major credits cards are accepted. Please speak with Dr. Bauchman first regarding a Health Savings Accounts. The full cost of the session is required at the time of service. Insurance co-payments are due at the time of service. Clients with insurance deductibles must pay the full session fee at the time of service until their deductibles have been met. Please remember that your insurance contract is between you and the insurance company. You are ultimately responsible for paying the fees that have been agreed upon.

 

Cancellation Policy 
Dr. Bauchman understands that life presents many extenuating circumstances. If you need to cancel your appointment, you will need to do so with a 24 hour notice prior to your scheduled appointment. If you cancel your appointment less than 24 hours, or do not show up for your scheduled appointment, you will be required to pay the FULL cost of the session.

 

Schedule your appointment 
Call the office number at 561-328-7567 to schedule your appointment. If we do not answer, the doctor may be with a patient or away from the office. Please leave a message and the office will return your call as soon as possible.

GOOD FAITH ESTIMATE

 

You have the right to receive a “Good Faith Estimate” explaining how much your health care will cost!

Under the law, health care providers need to give patients who don’t have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good FaithEstimate before you schedule an item or service. If you do, make sure the healthcare provider or facility gives you a Good Faith Estimate in writing within 3business days after you ask.

  • If you receive a bill that is at least $400 more for any provider or facility than yourGood Faith Estimate from that provider or facility, you can dispute the bill.

  • Make sure to save a copy or picture of your Good Faith Estimate and the bill.

  • For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises/consumers, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

PRIVACY ACT STATEMENT: CMS is authorized to collect the information on this form and any supporting documentation under section 2799B-7 of the Public Health Service Act, as added by section 112 of the No Surprises Act, title I of Division BB of the Consolidated Appropriations Act, 2021 (Pub. L. 116-260). We need the information on the form to process your request to initiate a payment dispute, verify the eligibility of your dispute for the PPDR process, and to determine whether any conflict of interest exists with the independent dispute resolution entity selected to decide your dispute. The information may also be used to: (1) support a decision on your dispute; (2) support the ongoing operation and oversight of the PPDR program; (3) evaluate selected IDR entity’s compliance with program rules. Providing the requested information is voluntary. But failing to provide it may delay or prevent processing of your dispute, or it could cause your dispute to be decided in favor of the provider or facility.

 

 

PAGO

 

Precios

$ 275 Consulta Inicial

$ 250 por sesión de 55

$ 350 por sesión de parejas 50 minutos

$ 200 (por persona) para la sesión de grupo de 90 minutos

 

$ 400 por Evaluación Psicológica Bariátrica para la cirugía (típicamente 1 hora y media para completar e incluye un informe clínico completo, escrito y detallado para el cirujano quien hace la referencia)

* Notar: No puedo aceptar todos seguros médico para la evaluación de la cirujía bariátrica ya que cada compañía de seguros tiene diferentes requisitos. Con mucho gusto le ayudará a obtener beneficios fuera de la red que le proporciona un recibo y envío de fax sus resultados de la evaluación a su compañía de seguros (con su permiso).

 

Seguro médico

Acepto seguro de TriCare y MEDICARE. Servicios psicológicos pueden ser cubiertos en su totalidad o en parte por su seguro médico. Por favor verifique su cobertura de salud haciendo las siguientes preguntas:

¿Tengo seguro de salud mental?

¿Cubre mi seguro de beneficios fuera de la red?

¿Cuál es mi deducible y ya se ha cumplido?

¿Hay un límite en el número de sesiones por año mis cubiertas de seguro de médico?

¿Cuál es el monto permitido por sesión de terapia?

¿Permite a mi seguro para la terapia de familia?

¿Se requiere aprobación previa?

 

Escala de tarifas ajustables

Algunos servicios reducidos están disponibles en un caso limitado por caso. Por favor, pregunte para más detalles.

 

Pago

Se acepta efectivo, cheque, y las tarjetas de créditos. Por favor, hable conmigo primero con respecto a PayPal y Cuentas de Ahorros Médicos. Se requiere el costo total de la sesión en el momento del servicio. Seguros co-pagos son debidos en el momento del servicio. Los clientes con los deducibles de seguros deben pagar la tarifa de la sesión completa en el momento del servicio hasta que se cumplan sus deducibles. Por favor, recuerde que su contrato de seguro es entre usted y la compañía de seguros. Usted es el responsable último de pago de las tasas que hemos acordado.

 

Declaración De Cancelación

Entiendo que en la vida presenta muchas circunstancias atenuantes. Si necesita cancelar su cita tendrá que hacerlo con un aviso de 24 horas antes de su cita. Si cancela su cita con menos de 24 horas o no se presenta a su cita se le pedirá pagar el costo total de la sesión.

 

Su cita

Llame al número de oficina al 561-328-7567 para establecer su cita. Si no contesto, puedo estar con un paciente. Por favor, deje un mensaje y le devolveré la llamada dentro del día.

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