Financial Responsibility & Payment Policy

As part of our commitment to providing excellent care, Guzman & Baker Behavioral Health Services wants to ensure our financial expectations are clearly outlined and understood. All patients are required to maintain a valid payment method securely on file. Any outstanding balance on your account must be paid in full prior to your next scheduled visit. If a balance remains unpaid by the time of your next appointment, that session will be rescheduled until the account is brought current.

Patients Utilizing Insurance Benefits

The “Provisional Period” To protect you from accruing significant unexpected costs, we implement a “Provisional Period” for all new patients utilizing insurance benefits. We will schedule your Initial Intake and up to two (2) follow-up sessions pending insurance adjudication. If we have not received a processed claim (Explanation of Benefits) from your insurance carrier by the completion of your third session, we may pause scheduling future appointments until your coverage is confirmed and the first claim is paid. Patient Responsibility & Payment Timeliness While we perform a courtesy verification of active coverage, you acknowledge that you are ultimately and fully financially responsible for all services rendered.

Standard Costs: All co-payments, co-insurance, and unmet deductibles are due within 30 days of the date your insurance claim is completely processed.
Overdue Balances: Any outstanding account balance remaining unpaid after 30 days will be automatically billed to your payment method on file. This charge will be processed on the first day of the calendar month following the 30-day period.
Claim Denials: Should your insurance carrier deny a claim for any reason (including but not limited to lack of medical necessity, coverage termination, or plan limitations), you agree to pay the full standard self-pay rate for all services rendered.

Self-Pay & Sliding Scale Patients

Payment Timeliness & Automatic Processing For patients electing self-pay or participating in our sliding scale program, payment in full is due at the time of service. To streamline your experience, your designated payment method on file will be automatically charged at the conclusion of the business day on which your services were rendered. Sliding Scale Eligibility Guzman & Baker Behavioral Health Services determines sliding scale eligibility utilizing the current year’s Federal Poverty Level (FPL) guidelines published by the Department of Health and Human Services (HHS), as adjusted annually based on the Consumer Price Index. Eligibility for this program is subject to annual review and income verification. If approved, your specific fee structure will be detailed in a separate written fee agreement, viewable at any time in the “Documents” section of your secure patient portal. FPL Tier Calculations:

Tier 1: Income at or below 138% FPL = 60% reduction ($60.00 per session)
Tier 2: Income between 139% and 200% FPL = 50% reduction ($75.00 per session)
Tier 3: Income between 201% and 300% FPL = 25% reduction ($112.50 per session)
Tier 4: Income above 300% FPL = 0% reduction (Standard Fee applies)