NBI Billing Policy

1. Payment is expected on the day of service.

2. Due to the complexity of current medical insurance system, it is impossible for NBI to know how much your co-pay and deductible will be or when your insurance company will pay for your claim.

3. It is our clinic policy to collect a retainer payment on the day of the service at the following estimated rate for patients who wish for us to file for their insurance claims: new patient psychiatric or neurological visit $150 and follow up visit $75. Psychotherapy 45 min session $90, EMDR (60 min) $120.  If you choose self-pay or do your own billing, the charge is $200 for new patient visit and $100 for follow up visit.

4. Once your insurance company made payment for your visit, your account will be adjusted with either credit or debt based on your insurance coverage.

5. Cancelation Charge: Cancelation within 24 hrs:  $25.  Missing appointment charge: $50

Name__________________                      Date: ____________