At yogaformentalhealth.com, one of our main priorities is the privacy of our visitors. This Privacy Policy document contains types of information that is collected and recorded by yogaformentalhealth.com and how we use it.

If you have additional questions or require more information about our Privacy Policy, do not hesitate to contact us through email at team@yogaformentalhealth.com.

Log Files

yogaformentalhealth.com follows a standard procedure of using log files. These files log visitors when they visit websites. All hosting companies do this and a part of hosting services’ analytics. The information collected by log files include internet protocol (IP) addresses, browser type, Internet Service Provider (ISP), date and time stamp, referring/exit pages, and possibly the number of clicks. These are not linked to any information that is personally identifiable. The purpose of the information is for analyzing trends, administering the site, tracking users’ movement on the website, and gathering demographic information.

Privacy Policies

You may consult this list to find the Privacy Policy for each of the advertising partners of yogaformentalhealth.com.

Third-party ad servers or ad networks uses technologies like cookies, JavaScript, or Web Beacons that are used in their respective advertisements and links that appear on yogaformentalhealth.com, which are sent directly to users’ browser. They automatically receive your IP address when this occurs. These technologies are used to measure the effectiveness of their advertising campaigns and/or to personalize the advertising content that you see on websites that you visit.

Note that yogaformentalhealth.com has no access to or control over these cookies that are used by third-party advertisers.

Third Part Privacy Policies

yogaformentalhealth.com’s Privacy Policy does not apply to other advertisers or websites. Thus, we are advising you to consult the respective Privacy Policies of these third-party ad servers for more detailed information. It may include their practices and instructions about how to opt-out of certain options. You may find a complete list of these Privacy Policies and their links here and finding : Privacy Policy Links.

You can choose to disable cookies through your individual browser options. To know more detailed information about cookie management with specific web browsers, it can be found at the browsers’ respective websites. What Are Cookies?

Children’s Information

Another part of our priority is adding protection for children while using the internet. We encourage parents and guardians to observe, participate in, and/or monitor and guide their online activity.

yogaformentalhealth.com does not knowingly collect any Personal Identifiable Information from children under the age of 13. If you think that your child provided this kind of information on our website, we strongly encourage you to contact us immediately and we will do our best efforts to promptly remove such information from our records.

Online Privacy Policy Only

This privacy policy applies only to our online activities and is valid for visitors to our website with regards to the information that they shared and/or collect in yogaformentalhealth.com. This policy is not applicable to any information collected offline or via channels other than this website.

Consent

By using our website, you hereby consent to our Privacy Policy and agree to its Terms and Conditions.

This privacy policy was created at privacypolicygenerator.info.

Financial Agreement and Payment Policy
Thank you for choosing Yoga for Mental Health. Please review this Financial Agreement and Payment Policy, which describes our schedule of fees for services, charges not covered by insurance, and payment policies.

Please be sure you understand the policies regarding cancellations and missed appointments, methods of payment, insurance reimbursement, and past due accounts. If you have any questions, please ask your provider prior to signing this Agreement and Policy.

Our service rates and corresponding health insurance billing codes (numbers starting with ‘90’ refer to mental health services.) This is not a comprehensive list and reflects the most common services provided. Additional codes may be used by your provider as deemed appropriate and will be detailed on your account and your Explanation of Benefits if applicable.

90791 Initial Consultation – Individual (50-60 min.) $245.00

90837 Individual Therapy (50-60 min.) $165.00

90846 Family Therapy (50-60min.) $185.00

90847 Couples Therapy (50-60min.) $275.00

INSURANCE REIMBURSEMENT

Yoga for Mental Health accepts and processes insurance payments through a variety of insurance providers and Employee assistance plans. We are are NOT enrolled as “preferred” providers (with whom you may find lower rates.) If you are using insurance or an Employee assistance provider to pay for our services, then we will:

Expect and accept payment of your co-payment amount at the time of service;
File your claim with the insurance provider
Receive payment from your insurance provider
Expect that you will pay your portion promptly or will incur fees as outlined.
CHARGES NOT COVERED BY INSURANCE

Case Management* $200.00 (pro-rated per 15 min.)
*Case Management may include indirect services such as writing letters, consultations for which a disclosure form is required, coordinating Court Advocacy services, and completing forms or reports.

Phone Consultation* (11-60 min.) $200.00 (pro-rated per 15 min.)
*Phone consultation may include scheduled or crisis response calls with client and/or legal guardians related to client concerns.

Medical Records Requests $25.00 per request (including standard shipping)
Supervision for licensing: $100/hour
Sliding scale (amount will be noted below)
ADDITIONAL FEES

Missed Appointment / late cancellations with fewer than 24 hrs. notice – $100
Retreat / Workshop cancellation fee- $100
Insufficient funds (bounced) check $25.00
Past-due accounts – $25.00 per month
Insurance Reimbursement

Yoga for Mental Health accepts and processes insurance payments through a variety of insurance providers and Employee assistance plans. If you are using insurance or an Employee assistance provider to pay for our services, then we will:

Expect and accept payment of your co-payment amount at the time of service;
File your claim with the insurance provider
Receive payment from your insurance provider
Expect that you will pay your portion promptly or will incur fees as outlined.
PLEASE NOTE

Yoga for Mental Health files insurance as a courtesy to you, and you (not your insurance company,) are ultimately responsible for your bill. If your insurance company denies a claim filed on your behalf, or pays for only a portion of a claim, then you are responsible to pay Yoga for Mental Health for the difference between the standard rate and the amount previously paid as copay.

PAYMENT

You will be expected to pay for either each session in full, or your insurance co-payment at the time of services provided. Accepted methods of payment are cash, check, credit card and electronic transfer through PayPal. PayPal payments can be sent to yogaformentalhealth@gmail.com. Checks should be made payable to Yoga for Mental Health.

If there is a balance on your account due to cancellation, late payment or other fees, it will be charged to your credit card on file. If your card is declined you will be contacted by phone and secure email in an attempt to collect payment. Your account will assume past-due charges on the following business day.

I agree to

allow Yoga for Mental Health to bill my insurance directly for services
give Yoga for Mental Health permission to release any information the insurance company may require in order to process payment
assign all of my rights to claims and payment by my insurance to Yoga for Mental Health
agree to assist with the claims process as required by Yoga for Mental Health or my insurance provider.
I understand that if my insurance plan requires that I meet a deductible amount prior to coverage by insurance, I will be responsible for the full session fee until the required deductible amount has been met. I acknowledge that not all issues, conditions, and problems dealt with in psychotherapy are reimbursed by insurance companies.

Private/Self-Payment for Services

You need to pay in full for services at the time services are provided. For events and program requiring deposits, deposits and payments may be refundable according to a schedule and must be requested in writing. Cancellation fee will be charged.

If there is a balance on your account due to cancellation, late payment or other fees, it will be charged to your credit card on file. Accepted methods of payment are cash, check, credit card and electronic transfer. If your card on file is declined you will be contacted by phone and secure email in an attempt to collect payment. Your account will assume past-due charges on following business day.

CREDIT CARD ON FILE

You are asked to provide credit card which will be kept on file to be used as a form of payment for fees incurred for co-pays, co-insurance, deductibles, late cancellations, missed appointments, returned checks, or past due account balances. In lieu of a credit card on file you may make a $100 deposit on your account which will be returned upon close of service as requested by either party.

A receipt will be e-mailed to you at the email address you specify in your account profile.

I understand that payment for services is due at the time services are provided.

I authorize Yoga for Mental Health to charge this credit card as needed according to the terms specified in this Agreement and Policy.

I have read the Agreement and Policy above, and I have been offered a copy for my records. I understand the policy and by my signature below I agree to be bound by its terms in association with outpatient services provided to me by Yoga for Mental Health. Any and all negotiated exceptions or special arrangements are listed below and require approval and are not valid unless signed by a representative of Yoga for Mental Health.

Patient name (printed)_________________________________________________________

Patient /Guardian signature:____________________________________________________ Date________