We participate in most insurance plans, including Medicare. If you are not insured by a plan that we participate , payment is expected in full at each visit. It is your responsibility to know your benefits and deductible. Please contact your insurance company before your first visit to verify your coverage.
Proof of insurance
All patients must complete our patient information form before seeing their therapist. We must obtain a copy of your current valid insurance to provide proof of insurance. If you fail to provide us with the correct insurance information in a timely manner, you may be responsible for the balance of a claim.
If your account is over 90 days past due, you will receive a letter stating that you have 20 days to pay your account in full. Partial payments will not be accepted unless otherwise negotiated. Please be aware that if a balance remains unpaid, we may refer your account to a collection agency and you and your immediate family members may be discharged from this practice. If this is to occur, you will be notified by regular and certified mail that you have 30 days to find alternative mental health care.
Co payments and deductibles
All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect copayments and deductibles can be considered fraud. Please help us in upholding the law by paying your co-payments at each visit.
We will submit your claims and assist you in any way we reasonably can to help get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.
Our policy is to charge $60 for missed appointments not canceled within a 24 hour period. These charges will be your responsibility and billed directly to you. Please help us to serve you better by keeping your regularly scheduled appointment. To cancel you can either call our main line at
631-744-5500 and speak to Roseanne or leave a message. You can also text a message at 631 - 202-8779. Which ever way you chose please make sure to leave your name , your appointment time and your therapist. Roseanne will get back to you to reschedule your appointment.
Non- covered services
Please be aware that some - and perhaps all - of the services you receive may be non covered or not considered reasonable or necessary by Medicare or other insurers. You must pay for these services in full at the time of visit.
If your insurance changes, or you change your address, get married, divorced or change your name please notify us before your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay your claim in 45 days, the balance will automatically be billed to you.
Our practice is committed to providing the best treatment to our patients. Our prices are representative of the usual and customary charges for our area. If you do not have insurance or we do not take your insurance please speak to Roseanne about out of pocket fees.
Thank you for understanding our payment policy. Please let us know if you have any questions or concerns.
This pre-intake form must be filled out prior to your first appointment.