Forms & Insurance

Insurance

Fees for our services are available upon request.  We accept Medicare Part B and Medicaid, and participate in many private insurance plans.  We also participate in the Anthem, MHS , United Healthcare and Caresource Medicaid programs . Patients, however, are strongly encouraged to check with their insurance plan representatives in order to determine if our office is a participating provider.

We are happy to file insurance claims on our patients’ behalf.  In addition to insurance reimbursement, fees for our services may be paid by in cash, check, credit card, or Paypal.

We may be able to reduce our fees for uninsured or under-insured persons.

Tele-counseling-Health-Services

OFFICE POLICIES

Every professional office must have a few “ground rules” in order to serve all consumers effectively.  Our office is no different, although we attempt to make our services as accessible as possible.  If you choose to use our office for your needs, please keep these simple policies in mind.

1.  We make every effort to have a staff member at the office by the scheduled time of the day’s first appointment.  However, we are a small office and, some days, the therapists double as the office staff.  If you have any questions about your appointment, please call or text Melissa at 765 318 1225.

2.  We ask that, if you cannot keep a scheduled appointment, please call at least 24 hours in advance.  This allows us to contact your therapist, who may be traveling a great distance to be at the office, and use your appointment time to complete other tasks.  If you call less than 24 hours in advance, a failed appointment fee may be charged.  The fee varies depending on the clinician the patient is seeing.

3.  Because our therapists live several miles from the office, we must enforce a “two miss” rule with reference to failed appointments.  That is, if a patient misses two appointments without providing at least 24 hours advance notice and this occurs within a single, two month (eight week) period, we must ask that the patient seek mental health services elsewhere.  We will, however, assist you in finding another provider if you wish.

4.  We ask that no weapons be brought to this office.  Our office is in a residential area with children.  If you have a weapon in your car or truck, please lock your vehicle securely and keep your weapon under cover.

5.  Please park in our driveway or in front of our building, on our side of the street.  Cars parked on the other side of the street are subject to tow.

6.  We provide assessment services to persons who have been convicted of sex offenses or who are on the sex offender registry.  However, these persons should notify us if they have been convicted of a sex offense, as they must remain in line of sight of a staff member at all times.  We are unable to provide counseling to persons with a sex offense conviction.

Counseling Interns are welcomed at our practice. We have a limited number of openings for interns throughout the year. We have been providing supervision to interns for 30 years. We like to share our experience and expertise to help nurture new therapists to the profession.

FORMS

Please download and fill out your forms. You can email them to us at beth@lpsbehavioralhealth.com.

PATIENT INTAKE FORM

AUTHORIZATION TO RELEASE INFORMATION

CONSENT AND AGREEMENT FORM

TELEMENTAL HEALTH CONSENT FORM

PATIENT INFORMATION PACKET

Get In Touch

Call

1-765-318-1225

Email

beth@lpsbehavioralhealth.com

Address

3630 Meadows Drive,  Martinsville, Indiana 46151

120 W. Seventh Street,  Suite 310  Bloomington, Indiana 47401

633 Library Park Drive, Suite K Greenwood, Indiana 46142