Financial Information for New Patients
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ACS is a state certified provider of outpatient mental health and substance abuse services. As
such, we are eligible for insurance reimbursement for most services. We participate in many EAP's
(employee assistance programs), HMO's, PPO's, and other insurance provider contracts. We
generally do not accept medical assistance except for those currently covered by specific managed
care plans.
Insurance claims will be submitted to your insurance carrier or carriers. This will be done as a
courtesy. Please present your insurance card at the time of your first registration/appointment.
The clinic does not accept responsibility for collecting your claim or negotiating a settlement on
disputed claims. All new patients must complete our application/insurance/information form
before seeing the doctor/therapist to expedite the billing process. Questions and explanations will
be provided at the time of the first appointment by representative of our insurance department.
Co-payments and deductibles are due at the time of each appointment. The office will call your
insurance company to check your benefits prior to your first appointment. This is not a guarantee
of benefits, as insurance companies only "quote" benefits. We are very willing to work with our
patients on billing and insurance questions or payment for our services. We also appreciate your
cooperation with this process.

Affiliated Clinical Services
Financial, Insurance, and Fee Information
Our practice is committed to providing the best treatment for our patients and we charge what is
usual and customary for our geographical area. An hour of treatment is generally considered to be
45-50 minutes.
Psychiatrist M.D.
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Evaluation
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$275
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Evaluation 30 minutes
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$175
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Individual/Family
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$212
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Individual/Family 30 minutes
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$145
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Medication Management 15 minutes
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$110
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Medication Management 30 min
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Masters Level Therapist
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Assessment
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$155
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Individual/Family
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$140
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Individual/Family (30 minutes)
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$94
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Psychologist Ph.D.
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Assessment
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$170
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Individual/Family
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$150
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Individual/Family (30 minutes)
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$100
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