T&C for Professional Services Agreement
1. Introduction
This Financial Engagement Agreement outlines the billing process for the professional services provided by Dr. Nadia McFarlane and her clinical team during your treatment at Westpark Springs Hospital and/or Changes PHP, IOP. It is important that you carefully review this document to understand your financial responsibilities.
2. Separate Billing for Professional Services
Please be informed that the professional services provided by Dr. Nadia McFarlane and her clinical team at Westpark Springs Hospital and/or Changes PHP, IOP are billed separately from any charges incurred at Westpark Springs. This means that you will receive a separate invoice from Nadia McFarlane MD PLLC d/b/a Impireum Psychiatric Group for the treatment and care provided by Dr. McFarlane and her team
3. Scope of Professional Services
The professional services covered under this agreement include, but are not limited to, psychiatric evaluations, medication management, therapy sessions, and any other treatments provided by Dr. McFarlane’s clinical team during your inpatient stay.
4. Payment Terms
You will receive an invoice from Impireum Psychiatric Group detailing the charges for the professional services rendered. Payment is due upon receipt of the invoice. Please note that payment for these services is again separate from any payments made to Westpark Springs for their services and facilities.
5. Insurance and Billing
If you have health insurance, we will submit claims to your insurance provider on your behalf. However, you are responsible for any co-pays, deductibles, or any portion of the charges not covered by your insurance. It is your responsibility to ensure that your insurance information is up to date and accurate.
6. Acknowledgment and Agreement
By reading and signing, you acknowledge that you have read and understood this Financial Engagement Agreement. You agree to the terms outlined above and accept responsibility for the payment of the professional services provided by Dr. Nadia McFarlane and her clinical team at Impireum Psychiatric Group.
Please keep a copy of this agreement for your records. If you have any questions or concerns regarding this agreement, please do not hesitate to contact our billing department at 877-631-0010 or billing@impireum.com.
Thank you for your trust in Nadia A. McFarlane MD PLLC d/b/a Impireum
Psychiatric Group.
Sincerely