LAKESIDE CENTER FOR AUTISM
Policies & Pricing
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.
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.
We strive to provide services that are based on your child’s recommendations from our professionals. We also work very hard to schedule to fit your needs. We may not be able to provide all the hours recommended when staring therapy. However, we will continue to build your child’s therapy schedule based on the recommendations.
There are times that we must adjust schedules and providers. We assure you that this is not detrimental to your child’s care. Research has shown that we need to vary the context in which a child learns skills and when we must shift therapists, this provides us with this opportunity. When this happens, your child may experience some initial set backs and increased behaviors, but this will go away as they create a new relationship and schedule with therapist.
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.
Please inform us immediately of any new insurance coverage.
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.
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.
Any check returned by your bank due to non-sufficient funds will incur a $25 fee to your account.
Other Policy Information:
With our mutually desired outcome of providing the best hope and future for your child our policies are as follows:
It is very important that you arrive on time for therapy. You are considered late for a session if you arrive 15 minutes or more after the session is scheduled to start. In the event there is a reason for arriving late that is out of your control, please communicate with us before the start of your session regarding the reason.
We are here to work with you on your schedule. If at any time a session time is too difficult to arrive on time, please communicate with our front office staff before the start of your sessions and we will work to reschedule your sessions to a time that works better for your family.
1st late arrival: On first late arrival, we will provide a policy reminder and you will not be charged for the session. Your session will commence from the time you arrive as long as you arrive within 30 minutes of your scheduled start time. If you arrive 30 minutes or later, the session will be cancelled, a policy reminder will be given to you and you will not be charged.
2nd late arrival: On the second late arrival, we will charge a late arrival fee of $75. The session will not be cancelled. Your session will commence from the time you arrive as long as you arrive within 30 minutes of your scheduled start time. If you arrive 30 minutes or later, the session will be cancelled, a policy reminder will be given to you and you will be charged a $75 late fee.
3rd late arrival: On the third late arrival, we will charge a late arrival fee of $145 and the session will be cancelled and we will work to move the session to a different day/time that will work better for your family.
LATE PICKUP 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 your last 60 minute session, debriefing will not occur. Our treatment staff will bring your child to a transition room and one of our staff will bring your child to you in the lobby when they are available. ***Please wait in the lobby until we can have staff bring your child to you.***
At :50 after the hour you have a 5 minute grace period. If you are more than 5 minutes late, you will be charged $5 per minute that you are late beginning at 5 past the 50 minutes. This charge cannot be billed to insurance.
Lakeside closes at 6 PM. In the event that you pick up after 6 PM, there will be a charge of $10 per minute after 6PM. This is in addition to the time from 5:55 to 6PM where you will be charged $5 per minute.