Established clients can access their scheduled appointments via the following link:
Telehealth Waiting Room for Dr. Mayse
***NOW PROVIDING TELEHEALTH SERVICES***
I currently do not have any openings for new clients. I will update this status when it changes.
To inquire about new client appointment availability, please send an email to email@example.com.
Pre-registration forms should be completed in advance of your scheduled appointment via the client portal (link will be provided at the time the telehealth intake appointment is scheduled). For couples, each partner will need to complete their own separate forms.
Policies and Practices to Protect the Privacy of Your Health Information (HIPAA)
Public Complaint Notification Statement
Fees & Insurance
I accept credit/debit/HSA card as forms of payment. As of April 7, 2022. I am no longer paneled by Blue Cross Blue Shield and am considered an out-of-network provider.
As an out-of-network provider, I’m happy to see you as a self-pay client. This means that you pay for your care with me out of pocket and then I will provide you with a superbill (a special type of receipt) for your sessions that you may use to seek reimbursement directly from your insurance company. Each insurance company determines their own coverage/ reimbursement rates for out-of-network providers, and you would need to contact your insurance company for specifics on your plan. I am happy to assist with this process.
Some prefer to not use their insurance at all and self-pay without the desire for insurance reimbursement, due to their desire to maintain the complete privacy of their treatment records and diagnoses. If you choose to opt-out of your insurance coverage and see me without seeking reimbursement from your insurance, I will provide you with a Good Faith Estimate of services for your financial planning purposes.
For additional information regarding my fees, please see my Practice Policies and Informed Consent for Psychological Services. Please feel free to contact me with further questions.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises/consumers or call 800-985-3059.