Pennock Center Policies

Pennock Center for Counseling is a nonprofit organization and relies on client fees for a major portion of its operating costs. You are ultimately responsible for all services you or members of your household receive from the Center.

All Fees are collected and due at the time of service.

 Sliding Scale Fee:

  • Fees will be determined by the staff based on financial documentation provided by the client in the form of pay stubs or tax returns. This documentation is due at the first session.

Victim Compensation:

  • If you wish to use victim compensation funds, you will need to provide the center with a copy of your acceptance letter on the first session.

Insurance:

  • You are asked to provide a copy of your insurance card at the time of service. Verification of insurance benefits is not a guarantee of payment. The contract for your insurance is between you and your insurance carrier.
  • You are responsible for all deductibles and co-pays. You are also responsible for all payments should your insurance not pay for services rendered.
  • You will be required to sign a Release of Information for insurance purposes so that payment can be made directly to Pennock Center for Counseling.
  • If you are choosing to pay out-of-pocket and not utilize your health insurance, we ask you to sign a statement indicating this choice.

Fee/Billing Policies:

  • All fees, including copays, are due at the time of service.
  • If, for some reason, fees are not paid, you will be billed for your outstanding balance.
  • Accounts need to be settled in a timely manner. If you are experiencing a hardship and would like to set up a payment plan, please contact our director, Jody Pierce, or our office manager.

Cancellation/No Show Policies:

  • All appointments must be cancelled 24-hours in advance of your scheduled appointment. After hour cancellation messages can be left on the Center’s voice mail.
  • You will be charged a $10.00 no show fee for appointments not attended (unless cancellation notice is given). This fee will be due at your next appointment.

Delinquent Accounts:

  • You will be billed for any delinquent payments. Failure to pay may result in termination of services. The decision to terminate services will be based on both clinical and financial information.
  • You will be held responsible for all past due fees should you return to the center and such fees will be due before services can resume.

Forms: