We now offer behavioral health services to our patients!
PHONE 937-492-1352 FAX 937-492-1353
Fees & Financial Policy
If you request any letters, forms, or any other paperwork to be completed, such as FMLA or disability forms, please be advised that there is a fee for paperwork. My fee is $160.00 per hour. FMLA paperwork generally requires a minimum of 30 minutes to complete due to the need for supporting clinical documentation. Short-term disability often takes longer to complete and may require additional assessments beyond my regular intake evaluation. The time required to make copies or prepare and send faxes, and any other administrative business (e.g., preparing releases of information or requests for records; phone calls to lawyers or other non-clinical calls) not directly related to the provision of clinical services, will also be assessed based on a rate of $160.00, with a minimum fee of $50.00.
I will not complete any FMLA, disability, other paperwork, or letters of support unless I have met with you for at least 4-6 sessions. I will also not complete any FMLA or disability paperwork if I do not believe I can support it based on what you have presented at intake and during sessions.
COURT APPEARANCE AND LEGAL FEES POLICY
There may be a time during your treatment at MFC that your provider may be subpoenaed to court for the purpose of litigation. Please be aware that your provider can only testify to the facts of the case and to their professional opinion. This does not guarantee that testimony will be solely in your favor. The same is true for records requests for the purpose of litigation. Furthermore, when your provider must go to court, all clients that are normally seen that day must be rescheduled, so fees will be assessed to make up for lost revenue. These fees are usual and customary, and within State of Virginia guidelines. None of these fees are billable to your insurance and are the sole responsibility of the client or requestor and/or legal guardian for a minor being treated by our practice.
If the provider is to receive a subpoena, then the attorney or office staff must contact RCC to set up a time within business hours to serve the subpoena. A minimum of 72 hours will be requested to accommodate schedule changes. Any requests with less than 72 hours will be assessed a rush fee of $250.
Fees for the purpose of court action are as follows:
- Therapist: $200/hour (billable in 15-minute increments)
- Psychiatric Nurse Practitioner:- $300/hour (billable in 15-minute increments)
- Mileage: $0.55/mile
- Filing document with the court:-$150 flat fee
- Retainer (due 72 hours in advance):- $1200
- Rush Fee (if less than 72 hours’ notice): $250
- Copy of files: $50 per file
- Letter of Recommendation/Clinical Evaluation: $120
- Phone calls: $160.00 per hour (billable in 15-minute increments)
Examples of court-related actions:
- Preparation Time
- Phone calls.
- Depositions
- Time required in giving testimony.
- Travel to/from court-related destination.
- Time away from office due to depositions or testimony
- All attorney/court fees and costs that are incurred by the provider as a result of the legal action.
The retainer will be due 72 hours before any requested court appearance. The remainder will be billed to the client, or the entire invoice is due within 30 days of receipt of invoice. If the full $1200 retainer is not utilized, the credit will be refunded. If the provider is subpoenaed and the case is reset after appointments have been cleared for the day, you will be responsible for an additional $500 to account for lost revenue from those day’s appointments. There may be times that your provider will be able to accommodate requests for court appearances.
Copyright © 2024 Macke Family Practice - All Rights Reserved.