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"The universe is so compassionate; it allows you to draw in what you need in order to heal yourself."
Oprah Winfrey
   607 Boylston St—2nd Floor—617 266 2266—Corner of Boylston and Dartmouth at Copley Square—email
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Insurance and Billing

Patient Agreement

Cancellation, Billing and Accounts Receivable Policy

CANCELLATION, BILLING and ACCOUNTS RECEIVABLE POLICY

    1. Rasi Associates requires that appointments be cancelled at least 24 hours (prior business day) from the appointment time. (For example: if the appointment is for Monday, 2 P.M., appointment must be cancelled by Friday at 2 P.M. Under 24 hours cancellations or missed appointments will be charged to client at full fee ($140 for individual; $155 for couples or family therapy). Insurance will not pay for missed appointments.

    2. Fees for short notice cancellations are due within 7 days of a missed appointment. If not paid, they will be charged to the client’s credit card within 10 days of the missed appointment.

    3. Copays are due at every session.

    4. Account statements are mailed by the 10th. of every month and they are due in full upon receipt.

    5. Rasi Associates requires that current credit card information be kept in the client’s record at all times. Rasi Associates will charge your credit card for any balance owed for more than 21 days from the last date of service or 21 days since the last payment, whichever is shorter.

    6. If the insurance company indicates that the client has a deductible, the client will pay a minimum of $85 for every session. Once the insurance company informs us of the correct allowed fee towards the deductible, the client’s account will be adjusted to reflect the new information.

    7. If the insurance plan denies a claim, Rasi Associates will work with the insurance company to determine the reason for the rejected claim. If the insurance company determines that the client is responsible for payment, the balance will appear on client’s next account statement and the payment schedule outlined above will be in effect.

    8. Unpaid balances will start accruing a 1.5% interest on each unpaid billing cycle.

    9. There is a $25 processing fee for bounced checks.

    10. Rasi Associates reserves the right to send delinquent accounts to collection.

    Rev. 3/07