THIS IS A GENERAL GUIDELINE TO SOME OF THE FEES AND PAYMENT OPTIONS AVAILABLE TO PATIENTS AT THE Nexus Group.
Fees are subject to change and reflect the complexity and type of service(s) provided. You will be notified thirty (30) days in advance of any changes in our fees. Any amounts not paid by insurance are your responsibility. Payment is due at the time of service.
We accept cash, check, debit cards, major credit cards, and electronic fund transfer. You are responsible for fees from credit card companies, collection agencies or banks due to non-sufficient funds, payment disputes, or non-payment of fees. A fee of $50 will be assessed for returned checks. Please notify staff if there is any change in your payment information or if any problem arises in your ability to make payments.
We will try to complete all work during our scheduled sessions. It may occasionally be necessary for us to charge on a prorated basis for professional services that require extensive time commitment such as report writing, telephone conversations lasting longer than 10 minutes, and consultations with other professionals that you have requested. After the first 10 minutes, the charge for these services will be billed at $50 per 10-minute increment. This amount is not covered by insurance and cannot be billed to insurance.
We are in-network provider for Highmark and UPMC Insurance:
We participate with UPMC and Highmark insurances, including their CHIP (Children's Health Insurance Program) products.
We do not participate in any other medicaid or any medicare programs. We do not participate in UPMC For Life or UPMC For You.
We ask that you verify your eligibility, deductible, co-insurance and copayment with your insurance company prior to scheduling your first appointment at The Nexus Group. If your insurance requires pre-authorization for services, it is your responsibility to obtain this authorization prior to treatment. If you fail to do so, you may be charged for fees and services that are not reimbursed.
AS of July 15, 2019:
The Nexus Group will be an in-network provider for Aetna insurance.
SELF-PAY OR OUT OF NETWORK INSURANCE:
Rates may vary according to treatment plan, time, and level of service delivery assessed as necessary by the physician. For those patients opting to self-pay for treatment, costs are generally as follows:
New patient evaluation/initial appointment: $350-$420
Follow up appointment: $250
All patient bills must be paid in full at the time of service. After your appointment, you will be provided with a “super-bill” with codes and details that reflect the services performed that day at The Nexus Group. You can then submit this as claims to your insurance for reimbursement.
If you change from self-pay to using insurance benefits, we cannot submit insurance claims for any prior-to-insurance sessions that you have already paid for out of pocket. We cannot provide refunds for any payments made prior to switching from self-pay to insurance.
FIRST APPOINTMENT DEPOSIT:
It is our policy to take a $25.00 deposit to hold a patient’s initial appointment. This will only apply to your first appointment with The Nexus Group. This deposit will apply towards any deductibles or copays that you may owe for that first appointment. If you fail to show for the initial appointment or cancel less than 48 hours prior to that appointment, your deposit will go towards the $300 cancellation fee assessed for missed or canceled new patient appointments. Please see the cancellation policy for more information.
For new appointments, there is a fee of $300 for late cancellations or No-show. The fee of $300 will also be charged for missed scheduled psychiatric/psychological consultations and any intake where you arrive more than 15 minutes late. This fee is not covered by insurance and cannot be submitted for insurance reimbursement. The $25 deposit to reserve the initial consultation will be applied to the $300 fee.
For follow-up appointments, there is a fee of $150 for late cancellations or No-show. The fee of $150 will also be charged for missed scheduled follow-up appointments and any appointments where you arrive more than 15 minutes late to the session. This fee is not covered by insurance and cannot be submitted for insurance reimbursement.
For all medication refills made without a scheduled follow-up appointment or made after a followup appointment was canceled/changed, there will be a $30.00 charge to prescribe the refill.
LEGAL FEES AND COURT PROCEEDINGS:
Court proceedings and any forensic work, even if required to testify by another party, are billed at $700 per hour.
SUBMITTING YOUR SUPER-BILL FOR REIMBURSEMENT THROUGH YOUR INSURANCE PROVIDER:
If The Nexus Group is out of network with your insurance provider we will give you a “super-bill” that you can submit to your provider for possible reimbursement. You can submit these super-bills directly to your insurance provider, or use an app to coordinate submission for you.
One app that facilitates this process is Better (getbetter.co/app). With this app, you'll simply take the super bill provided by The Nexus Group, take a photo, upload to the app, and they will take care of the claim submission. Better charges 10% of the money you get back. Any claims applied to your deductible or not paid by your insurance are processed for free.
We are providing this information as a courtesy but not as an endorsement or guarantee.
We request that a Credit Card on File be retained for all patients. In light of the additional staff and paperwork burden of collecting fees outside of clinic visits, if a bill or statement is requested or required to be sent in order to collect payment after the day of service and/or payment is not successfully processed using the credit card on file or a credit card on file does not exist, you will be assessed a billing fee of $15 for processing and collection of amount owed. For each month that the bill remains unpaid, a fee of 10% per month will be assessed for the outstanding balance.
Payment for services at The Nexus Group can be submitted in the following ways:
Credit Card on File: This is our preferred method of payment. We ask that a valid credit card or HSA/FSA card (if permitted by the terms of your HSA/FSA) be kept on file for each patient at the clinic. This allows us to process co-pays, deductibles, and fees in a timely manner. All information is kept secured and stored in a Payment Card Industry Data Security Standard (PCI DSS) certified payment gateway. The Nexus Group staff does not have access to the complete credit card information once entered.
We accept all major credit cards including Visa, MasterCard, American Express, and Discover. You will receive a receipt via email once your card is charged so please make sure you have the correct email address with us.
Check: Checks can be made payable to The Nexus Group, PC