Payment Policy - Patient Practice
Payment in full is due at the time of service. If your appointment lasts longer than your scheduled time, you may be charged for the longer appointment.
Insurance Information:
This office does not bill insurance. However, we will gladly provide you with an invoice containing all of the necessary information needed to submit it to your insurance for your direct reimbursement. It will be your responsibility to know what your mental health benefits are and if your insurance company will reimburse you to see an "out-of-network" or "non" provider and for how much. Please note that Dr. Holmberg is an "Opt-Out" provider for Medicare, which means that if you are on Medicare, you will need to sign a contract saying that you agree to NOT submit to Medicare for reimbursement.
Fee Schedule:
Please contact our office at 801-432-2077 for more information as fees are subject to change periodically.
New Patient Fees:
New patients must provide a valid credit card number in order to guarantee their scheduled appointment time. We will not charge your card unless you do not show up for your appointment without notice, in which case you will be charged the full fee. Cancellations less than 24 hours in advance will be charged half the initial fee. Cancellations 24 hours in advance will not be charged. After your first appointment we do not keep your credit card information on file unless you specifically request that we do so and fill out a credit card authorization form.
Cancellation and Missed Appointment Fees for Established Patients:
Please let us know as soon as possible if you need to cancel your appointment so that we may offer that time to other patients. Cancellations less than 24 hours in advance will be charged a cancellation fee. Missed appointments without notice will be be charged the full fee. Patients who continually do no show up for their appointments with or without notice may be referred to another provider.
Returned Checks and Unpaid Balances:
There is a $40.00 fee for returned checks. Your account will also be placed on a "no checks" status for one year. If payment is not collected in full within 120 days of any unpaid balances, Dr. Holmberg has the right to send your account to a collection agency, cancel any future appointments and refer you to another provider.
