5911 Northwest Hwy, Ste. 207
Crystal Lake, McHenry County, IL 60014
USA

©2018 BY MAIN ST. PSYCHIATRY, S.C.. PROUDLY CREATED WITH WIX.COM

Fax: 815-526-3094

815-526-3781

PAYMENT POLICY

Insurance Information

It is expected that patients will pay their share of the treatment cost at the time of service.  This includes the balance in full if the insurance deductible has not been met. We do accept self pay patients. If you are a self paying patient, it is expected that you will pay in full at the time of each session.


Payment Policies

We are an in-network provider for private insurance companies and Medicare. We do not participate in Medicaid. Insurance will be billed after each visit and patients will be expected to pay the projected balance at the time of service. A statement will be mailed monthly which will serve as your receipt if you are self-pay, may be submitted to your insurance company for reimbursement if you choose self submission, or used for tax purposes. Payment in full is required at the time of the visit irrespective of your insurance status. Credit cards and cash will be accepted. This may be charged per the policies below.

New Visits

  1. “No shows” will be charged 100% of the assigned fee;

  2. Cancellations within 24 hours of your appointment time: A $75 fee will be charged;

  3. Cancellations prior to 24 hours of appointment time: We will gladly reschedule and no fee will be charged.


Follow-up Visits

  1. “No shows” will be charged a $75 fee;

  2. Cancellations within 24 hours of appointment time: A $75 fee will be charged;

  3. Cancellations prior to 24 hours of appointment time: We will gladly reschedule and no fee will be charged.

  4. Two “no shows” is grounds for termination of treatment and referral to another practice.


Other Charges

  1. We may charge for phone calls and paperwork requested that require more than 10 minutes of our time, billed in 10-minute increments of our hourly fee. Examples include letters, forms, and consultation with other providers and treatment programs.

  2. Payment: We require payment in full at the time of each visit. We will provide you with a monthly statement for tax or insurance purposes. You are responsible for all charges irrespective of insurance payments you may receive that are less than our full charges. Cash and credit cards are accepted for payment. No checks.


Unpaid Balances

Patients who have balances in excess of $150 will be unable to schedule appointments with us until the balance is settled or payment arrangements are made. We reserve the right to collect money owed via collections agencies, small claims court or any other means allowed by law. Non-payment for services provided by us constitutes grounds for termination of treatment.