We offer many forms of communication to meet your needs and convenience here at Renewal: call, text, email, appointment reminders, etc. In fact, one of the best ways to communicate with us is via text messaging. With that said, help us best communicate with you!
Please list anyone you would like to give permission to access your appointment and billing information. This is often your spouse, family member, or caretaker. If you are the parent or guardian of the client who is a minor, please fill out your information below.
NOTE: This consent does not release private mental health information or diagnosis. Only permission to access appointment and/or billing information. An additional consent form is required to release private and confidential mental health information.
We accept nearly all major insurance plans. Here are a few: Aetna, Blue Cross Blue Shield, Blue Care Network, Cofinity, Beacon Health, Cigna, Hap, McLaren, Medicaid, Medicare, Tricare, and more!
We also want therapy to be affordable and accessible to all. In order to assist our clients who do not have insurance coverage, we have established a cash sliding fee scale that is applied based on family income levels. You may take advantage of this fee reduction if your family income is below $120,000 per year and you can provide Renewal Center with your 1040 tax report or other proof of income to demonstrate your income level.
Responsible Party - Individual Responsible for Financial Liability Incurred for Services
Providing a name and/or contact information below signifies that you have given Renewal Christian Counseling Center permission to share billing correspondence with the individual named and that they have agreed to be responsible for any balance due for services rendered.
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HIPAA Notice of Privacy Practices
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