FINANCIAL POLICIES
A $35.00 service charge will be charged for any checks returned for any reason for special handling.

As a courtesy, we will bill your insurance for you. However, we do not guarantee your insurance will reimburse for services rendered. You are responsible for all copayments, deductibles, coinsurance, and all charges incurred that are not covered by insurance. It is your responsibility to confirm with your insurance what your covered benefits are for MindFlow Mental Health AND your provider prior to your appointment.

Discounts are available for individuals who do not have insurance or prefer not to bill insurance. Below are the cash pay discount prices for MindFlow Mental Health; however your provider may have a different set of fees and it is their responsibility to discuss these with you if they are different from below:
1. Intake (90 minutes) = $580.00
2. Follow-up (60 minutes) = $384.00
3. Follow-up (45 minutes) = $320.00
4. Follow-up (30 minutes) = $256.00
5. Follow-up (15 minutes) = $128.00

MindFlow Mental Health offers a sliding scale fee for individuals who are unable to afford services. You may request an application by any of the following methods:
1. Email: info@mindflowmentalhealth.com
2. Call: 458-488-1000
3. Request in writing to 824 E Jackson St. Ste A Medford OR 97504

In accordance with the no surprises act, for individuals with high deductibles, please notify the office that you have a high-deductible health insurance plan. You will receive information regarding what you can expect your costs to be for services rendered before treatment.
If the above options do not apply to you or you still have questions, please reach out before services are rendered to ensure all your questions are answered.
A collection agency may be used to collect patient debt. Bills will be sent to collections after 120 days late and 3 attempts to collect payment in person, by phone (including leaving message), mail, email, or text message. MindFlow Mental Health and your provider may withhold records until back payment is received, unless imminently necessary for treatment by another provider.

APPOINTMENTS AND CANCELLATIONS

• When an appointment is scheduled with RoyLynn Underwood, PMHNP the scheduled time is protected for you and your family. RoyLynn Underwood, PMHNP may also have patients who have been waiting for an appointment for weeks, who could have been seen in the time slot where a no-show or late cancellation/reschedule occurred.

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•  The determination of whether someone is charged for a late cancellation/reschedule, or a no-show is based on whether we were notified at least 48 hours before your appointment or the last business day before a holiday weekend or weekend prior to your appointment. This is due to the fact that within this time frame, we MIGHT be able to fill that time slot. At all times, at least 48 hours’ notice is required to cancel or reschedule an appointment without a fee assessed but over a holiday weekend more time may be required (i.e., for a holiday falling on a Monday you must notify the office by 5 pm of the last business day before the holiday). You can be up to 5 minutes late from the scheduled start of your appointment, after this time it is considered a missed appointment and may be cancelled at the provider’s discretion.

 

• An appointment can be switched to a 45-minute session at the providers’ discretion to avoid a cancellation fee.

 

• An appointment can also be switched to Zoom at the providers’ discretion rather than in person to avoid a cancellation fee, with the exception of the initial appointment.

 

• For EXTENUATING circumstances, we may decide to waive the fee if notification is considered late. Please discuss this directly with RoyLynn Underwood if there is an extenuating circumstance preventing you from attending the scheduled appointment.

 

NO CHARGE WILL OCCUR:
If you notify us of a cancellation or reschedule at least 48 hours before your appointment or by 5pm on the last business
day before a holiday weekend or weekend prior to your appointment, there will be no late cancellation/reschedule or
missed appointment fee. Patient can alert a staff member in the following ways:

• By phone

• In person

• Phone message

• Portal messaging

CHARGE WILL OCCUR:
If patient notifies us of a cancellation or need to reschedule less than 48 hours before your  appointment or later than 5pm on the last business day before a holiday or weekend prior to your appointment or does not alert us of a cancellation (no-show), you will receive a late cancellation/reschedule or no-show fee:

•  1st = $75

•  2nd = $150

•  After 2nd = ongoing $300 and/or discharge from the practice.

 

MINORS
If you are a minor, your parents may be legally entitled to some information about your therapy. This will be discussed with you and your parents what information is appropriate for them to receive, and which issues are more appropriately kept confidential.
 

TERMINATION
Ending relationships can be difficult. Therefore, it is important to have a termination process in order to achieve some closure. The appropriate length of the termination depends on the length and intensity of the treatment. I may terminate treatment after appropriate discussion with you if I determine that the treatment is not being effectively used, you have 3 or more late cancellations/reschedules or missed appointments, or if you are in default on payment. I will not terminate the therapeutic relationship without first discussing and exploring the reasons and purpose of terminating. If treatment is terminated for any reason or you request another therapist, I recommend using Psychologytoday.com or your insurance carrier to locate another therapist to treat you. You may also choose someone on your own or from another referral source.
 

Should you fail to schedule an appointment or otherwise be seen in clinic for three consecutive months, unless other arrangements have been made in advance, for legal and ethical reasons, I may automatically consider the therapeutic relationship discontinued.
Terminating treatment may also occur when sufficient progress has not occurred, a patient has not fulfilled their responsibilities (as listed in the “Informed Consent for Treatment and Assessment” form), unresolvable communication challenges have occurred, or irreconcilable boundary violations have occurred.