This Practice Management Form is designed to ensure transparency and clarity around practice fees and it includes an explanation of the financial aspects of the therapist’s practice. (0523, practice management)

This form can be used by mental health providers to full the required good faith estimates of expected charges. This requirement goes into effect in January 2022.  A Good Faith Estimate must be provided within 3 business days. Information regarding services must be furnished within 1 business day of scheduling a service to be provided in 3 business days and within 3 business days of scheduling a service to be provided in at least 10 business days.  We recommend using the Psychology Forms Filler to individualize this form for your practice.   (2021, practice management, financial, forms)

This letter can be used by therapists to appeal an insurance payer denial when a claim has been denied due to timely filing. (0720)

This document outlines ways therapists can adhere to sound ethical practices regarding fees. (0720)

This form can be used to obtain permission to keep a client’s credit card number on file and charge it as fees are incurred.

This form can be given to clients to submit to their insurance companies for reimbursement.

A Superbill is an itemized form used by healthcare providers to reflect rendered services. A Superbill is the main data source for creation of healthcare claim, which is
submitted to payers to insurance companies or other payers.

This form can be given to a client as a receipt for services. There is one receipt for monthly services and one for individual sessions.

This form can be modified to state a therapist’s sliding scale schedule and to obtain a signed agreement regarding the terms of a reduced fee.

This fact sheet describes general ethical guidelines for billing and payment for therapeutic services. It includes links to the specific guidelines of various professional organizations. PDF