Receipt requests for reimbursement
If you would like to submit a statement of services to your insurance company for PPO benefit reimbursement or for your FSA/HSA purchases, complete the form below, and we will get it sent to you. Reimbursement will be paid directly to you.
Billing Statement
Please complete the form to request a statement:
Requesting Reimbursement
If you will be seeking reimbursement from your insurance company, we recommend reimbursify – an app to help patients who pay out-of-pocket to get reimbursed by their health insurance.
Once you sign up with their app you can upload the superbills we provide you with to simplify the reimbursement process from your insurance.
Reimbuirsify will submit your superbills to your health insurance on your behalf. The first claim is free to submit. After that, there is a small fee for them to submit your claims.
If you choose to file with your insurance company, be sure to call the number on your insurance card prior to your appointment to find out your out-of-network benefit details.
Good Faith estimate
Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.
- You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during treatment.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, or how to dispute a bill, see your Estimate, or visit www.cms.gov/nosurprises.
Florida