Fees
Initial Psychiatric Evaluation — $250
The session includes diagnosis with the development of a treatment plan.
Established Psychiatric Patient / Follow-Up — $150
The session includes medication management and psychotherapy.
Initial Evaluation/ Induction for Substance Use Disorder — $250
The session includes diagnosis and the development of a treatment plan
Follow-Up for Substance Use Disorder (Buprenorphine) — $150
The session includes a urine drug screen.
Follow-Up for Substance Use Disorder (Alcohol) — $150
The session includes administration of medication if it is naltrexone injection.
Repeat Urine Drug Screen — $25
Pregnancy Screen — $15
Ketamine Infusion — $250 (per session)
The session is up to 120 minutes and includes a private room with a recliner and any supplemental medications required during the treatment.
Administrative Fees— $50 per filing
Due to the amount of time required to file out patient forms, the facility has a processing fee per form.
Policies
Insurance
We currently only accept Aetna, Arizona Complete Health, Allwell, Ambetter, Blue Cross Blue Shield, Cigna, Molina/Magellan Complete Care, TriWest, UnitedHealthcare, and Zelis Healthcare insurance. Call to inquire about some of the discount card programs that our facility participates. We are self-pay for all other insurance companies. Upon request, a Superbill will be provided that you may submit to your insurance company for possible reimbursement. It is your responsibility as the client to contact your insurance company and maintain communication regarding potential reimbursement with your insurance company.
Cancellations
If you find that you need to cancel an appointment, please give as much notice as possible so that we can schedule people that are on our waiting list. You will be personally charged for the full cost of your appointment if not canceled at least 24 hours in advance other than for emergency reasons. It is ultimately your responsibility to communicate with the office.
No-shows will also be charged for the full office visit.
Payment
Full payment is required prior to the start of your appointment. A credit card will be required to remain on file to cover the fees associated with cancellations and no-shows.
Confidentiality
All information regarding the specific nature of your treatment is maintained at Samaria Behavioral Health Center LLC and is considered confidential within the office unless specified by you in writing. However, each provider at this office reserves the right to use specialty consultation with other medical providers at the office as deemed necessary. We follow HIPAA and maintain confidentiality. Samaria Behavioral Health Center LLC treats protected health information, medical records, and patient rights as confidential information. Patient information is protected and secured in accordance with HIPAA standards. Copies of our HIPAA policy and Patient Rights are available upon request.
Patient Rights & Responsibilities
Receive a written statement of his/her rights as a patient
Access medical care
Spiritual and emotional care
Compassionate, respectful care
Participate in his/her health care decisions
Consent to or refuse treatment
Consent to or refuse to participate in research or educational projects
Provide written consent to the release of information in the patient’s medical record or financial records, except as otherwise permitted by law
Confidentiality, privacy, and security
Know the identity and professional status of his/her providers
Receive truthful information regarding his/her illness along with knowledge of the benefits and risks of each alternative treatment
Request an itemized bill
Contact the patient representative regarding concerns about care
Be informed of the clinic’s policy on health care directives, and the patient complaint process
The clinic may disclose your protected health information to a third party to maintain your treatment or if the client becomes a danger to themself or others
Patients are responsible for...
Reporting complete and accurate information of matters relating to their health
Providing documentation of Advance Directives or Living Will/Health Care Power of Attorney, if they have formulated one or both
Reporting whether they understand the proposed treatment and what is expected of them
The consequences of their actions if they refuse treatment or do not follow instructions
Following instructions of agreed upon treatment plans
Keeping appointments or notifying the health care provider when unable to do so
Assuring that financial obligations for their health care are fulfilled
Following the facility rules and regulations affecting patient care and conduct
Being considerate of the rights of other patients and facility personnel
Being respectful of the property of other persons and of the facility
Samaria Behavioral Health Center is required by law to maintain the privacy of protected health information which is compliant with HIPAA standards.
If any individual has concerns about patient care and safety that the hospitals have not addressed, he or she is encouraged to contact the facility’s management at (480) 471-8980. If the concerns are not resolved through the facility, the individual is encouraged to contact the Arizona Department of Health Services at (602) 364-3030.