Gordon A Gunnell, MS, PLC - Phoenix Area Counseling
*Counseling & Psychotherapy for Individuals, Couples, & Families *Counseling & Psychotherapy for Addictions *Consultation
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Methods of Payment
GORDON A. GUNNELL, MS
Licensed Marriage and Family Therapist (LMFT)
Licensed Independent Substance Abuse Counselor (LISAC)
PAYMENT FOR SERVICES
Payment for services is made at each session by cash, credit, or debit card. You may also pay using your Health Savings Account (HSA) or Medical Savings Account (MSA). All fees paid for therapy are considered tax deductible medical expenses.
I am an out-of-network provider. If you have an out-of-network provision with your insurance carrier, it is very likely you will qualify for reimbursement of all or a portion of the fees you pay to me under the terms of your out-of-network benefit. I will collect payment from you at the conclusion of each session, and provide you with a completed insurance form that you can submit to your insurance provider for reimbursement. Please contact your insurance provider or HR department to determine (1) if you have an out-of-network benefit, (2) what your deductible is, and (3) the percentage of the fee the insurance will reimburse you after you have met your deductible.
Whether you select an in-network or out-of-network therapist for therapy services, your insurance company may request that you provide to them your protected health information (PHI) if they pay for or reimburse you for fees you pay for those services. Your insurance company also has the right to refuse payment or reimbursement if you do not permit them to access your PHI if they request it. Whether the insurance company reimburses you for fees you pay out of pocket (out-of-network) or pays the therapist directly after you pay your co-pay (in-network), your right to privacy and confidentiality is waived by the agreement you make with the insurer to reimburse or pay for your services.
Gordon A. Gunnell, MS, PLC