Policies & Pricing
LAKESIDE CENTER FOR AUTISM
It is your responsibility to provide us with your complete insurance information prior to beginning services here at LCA. It is very important that we obtain a copy of your insurance card, prior to, or on the day of your child’s evaluation. Billing your insurance is a courtesy that LCA extends to you. We will do our best to collect payment from your insurance carrier, however; in the event that any claim is denied, you understand that this amount will become patient responsibility. Any balance that is more than 90 days outstanding will immediately become patient responsibility.
Insurance Coverage:
All insurance plans are different. Your insurance coverage depends on your contract with your insurance carrier. It is your responsibility to know your benefit coverage and limitations. We cannot be familiar with every individual’s insurance plans, even group plans, since they can all vary considerably, however we will do our best to support you with this. In the event your insurance company denies payment, you are fully and directly responsible for any payment due. We do not bill secondary insurance.
Referrals & Authorizations:
It is your responsibility to contact our office to insure that authorization for your appointments has been obtained. You are bound by your insurance carrier to follow their rules and guidelines and this may require you to obtain a referral from your primary care physician before being seen in our office. Obtaining a referral is your responsibility and never the responsibility of LCA. Please note that referrals cannot be retroactively dated so you must obtain this prior to starting services, if your insurance company requires this.
It is your responsibility to keep track of your referrals and the number of visits they authorize. Please note that an authorization is not a guarantee of payment by your insurance carrier. We are not responsible for notifying you when you are out of authorized visits.
You ultimately remain responsible for payment of all services. We cannot be familiar with every individual’s insurance plans, even group plans, since they can all vary considerably.
Services Not Medically Necessary:
If your insurance has determined that the services your child receives here at LCA are not medically necessary, you will be responsible for these charges.
Usual & Customary Rates:
If you have an insurance carrier that we are not contracted with, we are under no obligation to accept usual and customary rates from an out of network insurance company.
New Insurance?
Please inform us immediately of any new insurance coverage.
Statements:
Please understand that you may not receive an invoice from us for up to 60 days after your initial evaluation. This can be due to several reasons, but most commonly is because your insurance may request additional information and/or documentation to prove the medical necessity before they will process your claim.
Private Pay:
Patients who do not have health insurance or those who choose to pay privately are expected to pay at time of service. We accept check, VISA or MasterCard (we do not accept cash). If you are interested in paying privately, please email us for a copy of our private pay pricing.
NSF Check:
Any check returned by your bank due to non-sufficient funds will incur a $25 fee to your account.
Other Policy Information:
Our expectation is that families attend 85% of their sessions. This is a commitment that will create the best opportunity for us to generate the best outcomes for your child and family. Families may be absent from 15% of sessions in consideration of illnesses and vacations.
Absenteeism is calculated from 30 days prior to the most recent cancellation. For example if you missed a session(s) on the 30th of May, we would determine your attendance from May 1st to the 30th.
NO SHOWS AND CANCELLATION POLICIES
No Shows:
If you do not show up for a session and do not call, you will be charged $145 for the missed session.
Cancellations:
If you cancel a session/s, you will be asked if you would like to reschedule. If the session is rescheduled, the cancellation will not negatively impact your attendance rate.
Day of Cancellation: A cancellation made less than 24 hours in advance will be charged $145 unless your child is sick or injured.
If you contact us to cancel a session with more than 24 hours notice, we will give you the opportunity to reschedule and it does not count against your attendance record. If you do not reschedule you may be charged for the session if your overall attendance from the current cancellation is less than 85%.
Vacations/Planned Absence: (Absent for more than 1 scheduled session)
***Vacation/Planned Absence policy goes into effect DECEMBER 5th 2011***
At LCA we currently schedule sessions on a recurring basis. When LCA is given advanced notice of planned absence we are able to offer clients on our wait list openings for one time sessions. In order to maintain your child’s scheduled therapy sessions when you are on vacation, you have the option to pay should your vacation result in attendance dropping below 85%. The fee drops with increased notice due to the increased likelihood that LCA will be able to fill the opening with a one-time session for clients on the waitlist.
Late Policy
If for any reason you are running late for a session, please call the Center ASAP to alert your therapist that you are still coming. Contact needs to be made at least 15 minutes prior to the start of your session. Even though your session might start late, sessions will still always end at the scheduled time. If you are going to be more than 15 mins late, the session will be canceled. The cancellation includes all sessions regardless of their length. For the first late cancelation, we will give you a copy of our cancelation policy as a reminder & free pass. The next time this happens, you will be charged privately for the missed session and please know that this CANNOT BE BILLED TO YOUR INSURANCE. The third time, you will be charged privately for the missed session and that session time will be offered to another client. We will work with you to schedule therapy at a time that is more convenient for you.
Late Pick-Up Policy
Sessions at LCA are scheduled in one hour blocks. We ask that you arrive at ten till the hour to ensure that we will be able to debrief about the session and provide information that can support your child in the home environment (you are always welcome to arrive earlier). If you are not present at 10 minutes prior to the end of a 60 minute session, debriefing will not occur. Your child will be in a transition room and will be brought to the waiting area by one of our transition staff. At the hour for 60 minute sessions, you have a 3 minute grace period. If you are more than 3 minutes late, you will be charged $5 per minute that you are late. This charge cannot be billed to insurance. In the event that your child is scheduled for a 30 minute session, please arrive 5 minutes before the 30 minute session is over to debrief.
Sick Child – Please follow our illness policy. If your child is sick with a fever or other contagious illness please keep him or her home so that it does not spread to others.
