Forms and Payment

Please find information below about our forms required for your first visit and information about payments.  Providers in our office accept most insurances and self-pay options are also available.  Please call our office if you have any additional questions.

Registering as a new patient

  • Before your first appointment, please complete the forms linked below. Please fax (678-541-7699) or email (admin@familiesforward.co), or bring the completed forms to your first appointment.
  • Please bring a copy of your insurance card to your first appointment. Payment is due at the time of service for all sessions. As a courtesy, Families Forward provides an estimate of your insurance benefits for you, however please contact your insurance company to confirm your mental health benefits.

Link for Child/Adolescent Paperwork: New Patient Services Agreement

Link for Adult Paperwork: New Patient Services Agreement

Link: HIPAA Agreement

Link: Services Agreement for Collaterals

Link: Social Media Policy

Payment

  • Payment is due at the time of service without exception. Families Forward accepts most major credit cards, excluding American Express, as well as check and cash.

Insurance

  • Our providers are on all the major insurance company panels, including Tricare, Amerigroup, Wellcare, Medicaid, and BCBS, among others. We strongly encourage our patients to call their insurance company to get information about their mental health services.
  • If you are using insurance, you will be expected to pay the full amount of your copay, coinsurance, and/or deductible prior to the time of service or you will be rescheduled. If it is unclear what your insurance agrees to pay, we will estimate these charges based on usual and customary charges until we receive an EOB from your insurance company. Your insurance company decides how they process claims (e.g. in network/out of network; deductible, etc) and any changes in the way they process the claim is not the responsibility of the provider and should be resolved through your insurance company. As a courtesy, we will file to insurance for you. If you have secondary insurance, it is your responsibility to inform Families Forward immediately.  Secondary insurance will not be billed unless we have the insurance information before the time of service. The patient is ultimately responsible for the cost of the session if insurance does not pay for any reason. If an insurance company changes the way they process a claim for any reason, the patient is responsible for charges reflected from these changes. For example, some insurance companies (e.g. BCBS, NAA, and smaller insurance companies) do not reimburse for certain diagnoses (e.g. behavioral disorders). If the insurance does not reimburse because of an uncovered diagnostic code, the patient is responsible for these charges.

 

Legal Services

  • Insurance DOES NOT cover legal services. If any of our providers are required to engage in legal services (e.g. talking to a lawyer, writing a letter, being subpoenaed, appearance in court, driving to court, etc), these services are charged at a rate of $250.00 per hour and a retainer is required in advance of participation in those services.

 

Academic Assessment

  • Often, insurance does not cover academic assessment. Please be aware that these services may become the sole responsibility of the patient if it is not a covered service with your insurance company.