The following represents the financial policies of Four Points Counseling Center including charging for services with card on file transactions.
Cards on File
It is the policy of Four Points Counseling Center (FPCC) that clients provide a credit or debit card that will be kept on file. Health Savings Account (HSA) cards may also be used for payment. Please note that due to the regulations of Colorado Medicaid and several third party payers, clients with these plans are not required to provide a card and will be informed of such upon scheduling.
FPCC requests cards on file primarily due to the administrative logistics of the practice, making payment collection at each visit faster, simpler and more convenient for both clients and therapists. Cards on file are used for any client payment responsibility which may include copay, coinsurance, deductible, and private pay amounts. Charges may also include amounts for unreimbursed services by insurance companies or fees for missed appointments.
We appreciate your adherence to this policy and are available to answer questions at any time. You may also revoke your authorization verbally or in writing by informing your therapist, calling 970-682-1337 or emailing info@fourpointscc.com.
Benefits Verification
If you utilize insurance or a third party payer to cover some or all of your session fees, FPCC will attempt to assist you in estimating your responsibility for payment. However, it is ultimately your responsibility to understand your benefits and coverage. FPCC is not responsible for any inaccuracy in relaying benefit information as thisisa courtesy only and you are strongly encouraged to contact your insurance company prior to beginning services.
If you consent to electronic communication, as reflected in the Disclosure and Consent to Treatment, we may contact you via the email address on file to communicate with you regarding balances owed, changes to your payment responsibility, or other billing-related matters.
Client Responsibility
You understand and agree that the fees for services are ultimately your responsibility. Any unpaid balances after insurance submissions are your responsibility and will be charged to the card on file. These amounts may include copays, coinsurance amounts, full fee amounts due to unmet deductibles, and fees for missed appointments and late cancellations. Clients not utilizing insurance will be responsible for the full fee for services. FPCC will provide access to the patient portal where you may view your account, request statements, and pay balances.
Routine Charges for Services
The card on file will be charged within one calendar week of the date of service. If you prefer that a different card be used than the one on file, or would like to use another method of payment such as cash or check, please let your therapist know at the time of your session.
Missed Appointments and Late Cancellations
Missed appointment and late cancellation fees are automatically charged to the card on file within one calendar week of the date of the scheduled service. Late cancellations are those that are canceled with less than 24 hours notice. The fee for missed appointments and late cancellations is $75.
Collateral Services and Miscellaneous Fees
Occasionally your therapist may provide a service for you, as requested by you, outside of sessions. These services, such as writing a letter, are not therapeutic services and as such are not covered by insurance. Rates for collateral services vary. Additionally, fees are listed for returned checks and court-related activity. Please reference the Professional Disclosure and Consent to Treatment for more information about client legal matters, as well as our request to refrain from asking for therapist involvement.
Collateral Services: Varies by therapist and service provided
Court-Related Matters: $250/hour (including but not limited to preparation and travel time)
Returned Checks: $20 per check
Information Storage
Card information is stored via PCI-compliant encryption with International Bancard.