Financial Policy - Payments & Fees
Foundation Psychiatry, P.C. -- 35 Collier Road NW, Suite 425, Atlanta, GA 30309 -- Tel: (404) 902-6184 | Fax: (404) 400-1952
Effective Date: [09/17/2026] | Version: 2
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Financial Policy — Payments & Fees
Financial Policy — Payments & Fees
Insurance
Insurance
Foundation Psychiatry is in-network with many insurance plans. For patients with active, accepted insurance, we will bill your insurance directly, and you will be responsible for any applicable copay, coinsurance, or deductible per the terms of your specific plan.
Self-Pay / Out-of-Network Rates
Self-Pay / Out-of-Network Rates
The rates below apply to patients who are self-pay, out-of-network, or without applicable insurance coverage on file. Current self-pay rates are listed here; patients will receive advance notice of any change in self-pay fees before the new rate applies.
Appointments with Psychiatrist — Initial Evaluation: $450; Follow-Up (up to 25 minutes): $300
Appointment with Advanced Practice Provider (Nurse Practitioner or Physician Assistant) — Initial Evaluation: $350; Follow-Up (up to 25 minutes): $150
Individual Therapy Session — 1 Hour Session: $160 (rate to be updated to $200 upon provider licensure; patients will be notified in advance of this change); 1/2 Hour Session: $100
Missed & Cancelled Appointments
Missed & Cancelled Appointments
Please arrive on time to your appointments. We are only able to see patients at their originally scheduled times. We ask that you notify us at least 24 hours prior to your appointment time to cancel.
If you do not provide at least 24 hours' notice, or do not attend your appointment, a $75 fee may be charged, except where prohibited by law, Medicaid rules, or your health plan contract. This fee is billed directly to the patient and is never submitted to insurance.
Foundation Psychiatry will not charge Georgia Medicaid members a missed-appointment fee, late-cancellation fee, failed-technology fee, or similar charge when prohibited by Medicaid rules, the applicable managed-care plan, or other applicable law.
Telehealth Technology Failures
Telehealth Technology Failures
If a telehealth visit cannot be completed because of a documented technology, platform, or connection problem, staff will review the circumstances before assessing a missed-appointment fee. Georgia Medicaid members will not be charged for failed or unsuccessful telehealth transmissions or related technology costs.
Medication Refills
Medication Refills
Medications will only be prescribed at appointments with the psychiatrist, nurse practitioner, or physician assistant. Medication will not be refilled outside of a scheduled session. Please call our office in advance to set up a medication management appointment if you feel you will run out before your next scheduled visit.
Repeated Missed or Late-Cancelled Appointments
Repeated Missed or Late-Cancelled Appointments
Repeated missed or late-canceled appointments may result in a review of whether the practice can continue to provide non-emergency services. Any decision to end the treatment relationship will be made by the treating clinician and practice leadership, consistent with patient safety, professional standards, payer requirements, and applicable law.
Acknowledgment
Acknowledgment
I acknowledge that payments are due at the time of service and that I am responsible for any fees incurred by missed or cancelled appointments, as described above.
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By submitting your signature, the parties agree that this agreement may be electronically signed. The parties agree that the electronic signatures appearing on this agreement are the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.