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Equine Counseling                          $200      

Group Counseling (equine)          $75/person

Play Therapy                                     $150

Individual Therapy (Not EAMHL)   $150  

Group Counseling (non-equine) $50/person

Couples/Family Therapy               $200

All counseling clients have a right to receive a Good Faith Estimate per federal law as of January 1, 2022. A Good Faith Estimate provides clients with the expenses they can reasonably expect for mental health care services provided by our practice. 

You can access our Good Faith Estimate policy and procedure information HERE.

Sliding Fee Schedule Policy

POLICY: To make available discount services to those in need. 

PURPOSE: This program is designed to provide discounted rates to those who qualify.

Spirit Therapy Services, LLC will offer a Sliding Fee Discount Program to all who qualify. Spirit Therapy Services, LLC will base program eligibility on a person’s household income and size of household and will not discriminate on the basis of age, gender, race, sexual orientation, creed, religion, disability, or national origin. The Federal Poverty Guidelines (http://aspe.hhs.gov/poverty) are used in creating and annually updating the sliding fee schedule (SFS) to determine eligibility. 

PROCEDURE: These guidelines are to be followed in providing the Sliding Fee Discount Program.

Notification: Spirit Therapy Services, LLC will notify patients of the Sliding Fee Discount Program by: 

● An explanation of our Sliding Fee Discount Program and our application form are available upon request through our client portal.

● Spirit Therapy Services, LLC places notification of Sliding Fee Discount Program on their website.

Requests for Discount: Requests for discounted services may be made by clients or parents/guardians of minor clients.

Discounted services would apply effective the date of application approval going forward.

Information and forms can be obtained upon request through client portal.

Administration: The Sliding Fee Discount Program procedure will be administered through the client’s therapist or other designated personnel. Information about the Sliding Fee Discount Program policy and procedure will be provided and assistance offered for completion of the application upon request. Dignity and confidentiality will be respected for all who seek and/or are provided discounted services.

Application: The client must complete the Sliding Fee Discount Program application in its entirety. By signing the Sliding Fee Discount Program application, persons authorize Spirit Therapy Services, LLC access in confirming income as disclosed on the application form. Providing false information on a Sliding Fee Discount Program application will result in all Sliding Fee Discount Program discounts being revoked and the full balance of the account(s) restored and payable immediately.

Initial Application: If an application is unable to be processed due to the need for additional information, the applicant has two weeks from the date of notification to supply the necessary information without having the date on their application adjusted. If a client does not provide the requested information within the two week time period, their application will be re-dated to the date on which they supply the requested information. Any accounts turned over for collection as a result of the client’s delay in providing information will not be considered for the Sliding Fee Discount Program.

Renewal Applications: A client who receives discounted services under this policy is required to submit an updated application every 12 months or if their financial situation changes. Failure to meet the annual financial information requirement may result in the patient no longer being eligible for the Sliding Fee Discount Program. If a client is delinquent in meeting the updated annual application requirement, Spirit Therapy Services, LLC will send the client a notice they are being terminated from the Sliding Fee Discount Program unless they submit the required financial information within the time frame (10 business days) noted in the letter. If a client does not submit the renewal information, they are no longer eligible for the discounted services per the date in the notice letter.

Discounts: Discounts will be based on income and family size only. Spirit Therapy Services, LLC defines a Family as head of household, spouse and dependent children.

Income includes: earnings, unemployment compensation, workers' compensation, Social Security, Supplemental Security Income, public assistance, veterans' payments, survivor benefits, pension or retirement income, interest, dividends, rents, royalties, income from estates, trusts, educational assistance, alimony, child support, assistance from outside the household, and other miscellaneous sources. Noncash benefits (such as food stamps and housing subsidies) do not count.

Requirements: Applicants must provide the following: prior year W-2 and two most recent pay stubs. Self- employed individuals will be required to submit detail of the most recent three months of income and expenses for the business. Adequate information must be made available to determine eligibility for the program. Clients who are unable to provide written verification must provide a signed statement of income, and why he/she is unable to provide independent verification. This statement will be reviewed and final determination as to the sliding fee percentage will be made. Self-declared clients will be responsible for 100% of their charges until management determines the appropriate category. 

Updates: The sliding fee schedule will be updated during the first quarter of every calendar year with the latest federal poverty guidelines, http://aspe.hhs.gov/poverty.

Notice: The Sliding Fee Discount Program determination will be provided to the applicant(s) in writing and will include the percentage of Sliding Fee Discount Program write off, or, if applicable, the reason for denial. If the application is approved for less than a 100% discount or denied, the client and/or responsible party must immediately establish payment arrangements with Spirit Therapy Services, LLC. 

The applicant has the option to reapply after the 12 months have expired or anytime there has been a significant change in family income. When the applicant reapplies, the look back period will be the lesser of six months or the expiration of their last Sliding Fee Discount Program application.

Storage of Information: Information related to Sliding Fee Discount Program decisions will be maintained and preserved in a centralized confidential file located in the (title of staff member responsible for program) office, in an effort to preserve the dignity of those receiving free or discounted care.