for personal growth and recovery
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Financial obligation

POLICY I

If you have Medicare, you will need to see specific Medicare therapists who can bill Medicare for our agency. If you have only Medicare, there may be a co-pay, you will be responsible for. If you are a resident of Iroquois County, you will be able to apply for our sliding scale fee, which would be your co-pay with your Medicare insurance.

POLICY II

If you have Medicare and Medicaid, there would be no additional fee to you. Medicare and Medicaid would both pay for your services to our agency.

POLICY III

If you have only Medicaid, there would be no additional fee to you. Medicaid would pay for your services to our agency.

POLICY IV

If you have Private Insurance only, we would ask that you check to see if our agency is an in-network provider for your type of coverage. The insurance company can also give you information as to what specific therapists are covered under your plan.

You may need to pay a regular co-payment at the time of each session with us and you may have to meet a deductible. Your insurance company would be able to give you all of this information.

If you need to pay a regular co-payment and are a resident of Iroquois County, you will be able to apply for our sliding scale fee, which might be less than your required co-pay, and which the Center would accept as your co-pay.

POLICY V

If you have no Medicare, Medicaid, or Private Insurance and live in Iroquois County, you will be considered self-pay. You will be able to apply for our sliding scale fee by completing an appropriate form (4506T Form). This would be completed at the time of your mental health assessment. Once information is gotten back about this, you would then be charged per session according to our sliding scale fee, in conjunction with the information obtained from the 4506 form.

POLICY VI

If you have no Medicare, Medicaid, or Private Insurance and live outside of Iroquois County, we still feel it is important to meet your needs. It would then be our goal to enter in to a contract with you to pay a specific amount for specific services which you feel you can afford. The contract that is set may be modified from time to time, based on your changing financial needs. Once a contract is set, you will be responsible for the specified charges, based on the agreed fee.

POLICY VII

There are some specific services offered through our Center that must be paid privately and in advance. These include fees for DUI evaluations and updates, Risk Education classes, and Domestic Violence evaluations and sessions you may attend.

For all clients receiving services here, you will have contact with our billing staff to have a full understanding of expectations around payment of your bill. You may call ahead to clarify your coverage with our billing department at 815-432-5241, Ext. 245. The Reimbursement Specialist may attend a portion of your assessment session to clarify the financial agreement. At the time your services begin, we will have you sign a fee agreement that signifies your understanding of what coverage you have or do not have, and your set fee. If there is any change in your coverage or financial situation, clients are expected to notify IMHC immediately.

Please feel free to contact us at any time for questions about your bills.

 
 
 
Iroquois Mental Health Center | 323 W. Mulberry Street | Watseka, IL 60970 | 815-432-5241 | TDD. 815-432-4254 | Fax. 815-432-4537

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