Our practice does not accept insurance and is self-pay only. We will be happy to provide any information needed to submit for out-of-network reimbursement from your insurance.
*Please note that our fees are changing. New patient fee changes are effective immediately as of 2/4/2022. All other patients will see an increase in fees starting June 2022.
New Patient Medication Visits - $300
Follow-up Medication Visits - $125
Pharmacogenetic Testing (May be covered by insurance, call insurance company to inquire)
Medication Refills (between appointments) - $25 (plus postage if mailed)
Missed and Late New Patient Medication Visit - $150
Missed and Late Follow-Up Medication Appointments - $75
Returned Check fee - $35
Paperwork/Letter Fees- $25.00-$100.00
Medical Records- 83 cents/page plus postage; $22.88 preparation fee if required
Missed/Late Appointment Fees: All appointments must be canceled at least 24 hours in advance of the appointment time or the patient will be charged a missed appointment or no-show fee of $75.00 for follow-up appointments or $150.00 for new evaluations and hour long appointments. THA securely stores credit card information on file with patient's prior written authorization. Please note that if you miss an appointment or cancel with less than 24 hours notice that the credit card on file may be charged the missed appointment fee or the patient may be billed for this fee. If a patient arrives more than 10 minutes past the scheduled appointment time, it may be necessary to re-schedule the appointment and a missed appointment fee may be charged.
Returned Checks: returned checks will incur a $35.00 bank penalty fee on top of the balance that is unpaid as a result of a returned and unpaid check. In most cases we will not be able to accept a check as a form of payment from a patient once a check has been returned.
Paperwork/Letter Fees: If needed, your provider can write letters and complete medical forms for a fee. The fee is based on the time needed to complete the request. In most cases, please allow 1 business week for your paperwork or letter to be completed. Complex paperwork may require an appointment.
For patients who need paperwork completed for FMLA or Short-term disability, the patient must be established with the practice for at least 3 months and see your prescribing provider every 4-6 weeks. It is also recommended that the patient be attending therapy every 1-2 weeks.
Emotional Support Animal (ESA) letters
ESA letter eligibility will be determined on a case by case basis by your provider and is not guaranteed.
Medical Record Fees: Patients may request a copy of their medical records by completing and signing our record release form in person with proper photo identification. It may take 7-10 business days for records to be prepared. The charge for medical records is 83 cents per page (this is the current rate per DHMH Maryland website) plus any applicable postage fee if records are to be mailed. A preparation fee of $22.88 may be charged to hospitals and insurance companies if they are requesting records.
For all billing inquiries please call
Email Kay at firstname.lastname@example.org
(Please leave a detailed message)
Payment is due at the time of service.
We accept most major credit cards: Visa, Mastercard, American Express and Discover. We also accept Health Savings and/or Flexible Spending account cards and personal checks.
We will provide you with a statement with all of the necessary coding so that you may submit
this expense to your insurance company/benefit plan for reimbursement. However, please note that we cannot guarantee your insurance company will provide reimbursement and ultimately patients are financially responsible for services received.