Outpatient Practice Policy Guidelines

Acknowledgement of Late Cancellation/No Show and Point of Service payments.

Cancellations/No Show

New Patients: If you cannot make your first appointment, call 513 536-0570 to cancel or reschedule. Failure to cancel with more than 24 hours’ notice will result in you being responsible for the full fee of the initial intake session should you choose to reschedule.

Established Patients: Follow-up appointments that you do not cancel with more than 24 hours’ notice will result in a Late Cancellation charge. If you check-in/connect more than 10 minutes late for a 30-minute appointment or if you check-in/ connect more than 15 minutes late for a 60-minute appointment this fee will also apply. If you do not check-in/connect to your scheduled appointment a No Show fee will apply. This fee is not covered by insurance companies and is your responsibility. This fee varies by the type or length of the scheduled appointment and the clinician’s discipline.

Table of fees for Late Cancellations/ No Shows
Scheduled Appointment Time		Fee
MD 60 min.		$150.00
MD 30 min.		$100.00
Advance Practice Nurse 60 min		$100.00
Advance Practice Nurse 30 min		$50.00
Psychologist/Therapist 60 minute		$100.00
Psychologist/Therapist 30 minute		$50.00
Group Psychotherapy		$50.00
Dietitian Initial		$100.00
Dietitian Follow-up		$50.00

Point of service payments

In the event your insurance plan has a clause that requires you to pay a portion of charges for services, such as a Copayment, Deductible or Co-Insurance amount, we will collect the amount at the time of service.

If you have a High Deductible Health Plan (HDHP), you pay all your health care service costs until you reach the plan’s in-network deductible. After reaching the deductible, you pay co-insurance until you reach the plan’s in network out-of-pocket maximum. At that point, the health plan pays the rest of the health care costs when you receive services.

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