Financial Policy

Thank you for choosing Hamm Clinic as your mental health care provider. The following is a statement of our Financial Policy.

Missed Appointments:

Hamm Clinic requires 48 hours notice to cancel a psychiatry appointment and 24 hours’ notice to cancel a therapy appointment. Clients will be charged $50.00 for a missed or late cancel therapy appointment, and $75.00 for a missed or late cancel Psychiatry appointment. Sliding fee scale fees do not apply to failed appointment charges.

Arrangements can be made when necessary for clients to carry a balance on their account.

Clients with questions regarding their balance, or who state they are unable to pay their current per session fee, should be referred to the Billing and Operations Specialist.

Failure to pay agreed upon fees may result in the suspension or termination of services.

Active client accounts with a balance over $400 will be reviewed on a monthly basis by management. Discussions regarding these accounts may be held with client and/or clinical staff as appropriate.

Payments

  • All Co-Pays, Co-Insurance, payment plan, and sliding fee scale payments are due at the time of service.
  • We accept Cash, Checks, Credit or Debit Cards.
  • All clients must complete our Registration forms including a signed fee agreement before seeing a clinician.

Clients without Insurance

Clients without health insurance may apply for the sliding fee program. Those who wish to apply for the sliding fee program will be required to provide specific documentation as requested to establish eligibility for the sliding fee prior to their third appointment. A third appointment may be delayed until documentation requirements are met.

Clients without insurance, who are eligible, will be required to apply for Minnesota Healthcare Programs, Medical Assistance/Minnesota Care. Clients who fail to provide evidence of their application as detailed in clinic policy may face suspension or termination of services

Clients using a sliding fee will be required to re-establish their eligibility bi-annually or whenever they have a significant change in their financial circumstances.

If a client without insurance declines the opportunity to apply for a sliding fee by checking the ‘I prefer not to participate’ box and signing the application, they will be required to pay full fee.

Clients with Health Insurance

Clients with insurance are required to use their insurance when receiving services at Hamm Clinic.

Clients with insurance are responsible for the client portion of the Hamm Clinic fee as indicated by their insurance company benefit design and their insurance company explanation of benefits (EOB).

Except as indicated below, clients with a deductible are responsible for the client portion of the Hamm Clinic fee. Clients with a deductible will be informed of their approximate per-session responsibility. Until the actual per-session liability is established, the full fee for service will be put on the client’s account. Upon receiving an EOB the client will be informed of their actual financial responsibility and the client’s account will be adjusted as necessary.

Except as indicated below, clients with insurance may apply for a payment plan for amounts owed to Hamm Clinic. Clients remain financially responsible for the client portion of the Hamm Clinic charge, as determined by their insurance company EOB, but Hamm Clinic will accept as per session payment the approved amount as indicated by the payment plan. The client will remain responsible for their account balance after care at Hamm Clinic is completed.

Clients who have insurance with a deductible of $5,000 or more that has not been met may apply for the sliding fee scale program (using existing payment plan eligibility tables). After the deductible has been met the client’s financial responsibility will be as indicated on their EOB, or the existing sliding fee amount, whichever is less.

Student clients who have insurance that has a deductible of $3,000 or more that has not been met may apply for the sliding fee scale (using existing payment plan eligibility tables) if they are students at a college, university, or technical school and can provide documentation of current enrollment. The client’s total financial liability will be the per visit amount of the approved sliding fee amount. After the deductible has been met the client’s financial responsibility will be as indicated on their EOB, or the existing sliding fee amount, whichever is less.

Medicare clients who do not have any supplemental insurance coverage may also qualify for sliding fee scale services if their financial eligibility meets Hamm Clinic eligibility tables.

If a client has no mental health coverage through their insurance, they would then qualify for the sliding fee program based on their income. All previously stated requirements must be met.

IMPORTANT INFORMATION

When insurance is filed, please remember that your insurance company has access to all of your records. Also please be advised that while Hamm Clinic will attempt to verify your financial responsibility, Hamm Clinic cannot guarantee insurance coverage or payment by your insurance company. Any and all charges incurred are ultimately the client’s responsibility.

  • If a client gains, loses, or has a change in insurance coverage they are required to inform the clinic immediately.
  • It is ultimately the client’s responsibility to confirm if Hamm Clinic is in network with their insurance company.
  • If a client chooses to use their out of network benefits for services at Hamm Clinic, or if Hamm Clinic is out of network for a client who has no out of network benefits, the client is responsible for full fee and that client will not be offered the opportunity to apply for a payment plan.
  • Clients who have exhausted their mental health benefits may qualify for a sliding fee based on their income, however they will lose eligibility of the sliding fee at the time of the renewal of their insurance plan year.