Fees & Payments

Please be aware of the following Policies:

  • We do charge a $100.00 fee for any missed or cancelled appointment with less than a 24-hour notice which will be applied to your account and will be charged to your credit card on file.
  • As a courtesy, Kalos Comprehensive Care Counseling attempts to determine your financial liability with the insurance information you provide us prior to your initial visit. Ultimately, verifying your coverage and amount owed is your responsibility. If you have any questions regarding your mental health insurance coverage please call the number on the back of your insurance card regarding your mental health coverage and benefits.
  • We accept some Employment Assistance Program’s (EAP). Please note, we can only apply the EAP authorization to the patient listed on the EAP authorization. It is policy that the usage of your EAP benefits be applied once per year per patient per provider. Other family members who receive an EAP authorization are required to see a different provider.
  • Payment is due at time of services are rendered. Patient is responsible for all deductible amounts, co-payments, coinsurance, and any remaining balances unpaid by your insurance carrier.
  • Once your insurance claims have paid should there be a balance, unless other arrangements have been made, we will charge the most recently provided card per your signed Financial Agreement.
  • We bill all primary insurance. We do not currently bill secondary insurance; however, we are happy to provide you with the necessary documents to file any secondary insurance.
  • Patients are expected to show for appointments at their scheduled time. If you arrive 15 to 20 minutes late, we are required to reschedule your appointment and charged you the $100.00 “no show” fee for the missed appointment to the card on file that you put on your Financial Agreement.
  • Patient is responsible for the full rate we charge the insurance company when payment is denied should we be informed it was denied due to your premium not been paid, termination of coverage, or lapse in coverage.
  • All credit cards used for account payments will be assessed a 3.75% (+ $.30) credit card convenience fee, alternatively, you may pay with cash or check and avoid the convenience fee.
  • Any check returned due to insufficient funds (NSF) will result in an additional charge of $35.00. The amount for which the check was written, the $35.00, any unpaid balance of the account will be charged to your credit card kept on file per the financial agreement.
  • Any questions about your patient statement, please call 844.955.2616.

  • Any questions regarding patient billing, call 866.374.4232.

Self-pay rates (fee change is effective June 1, 2020):

  • All Initial Sessions: $160.00
  • Couples Ongoing Therapy Sessions: $150.00
  • Family/Minor Ongoing Therapy Sessions: $140.00
  • Individual Ongoing Therapy Sessions: $120.00

Other Services:

  • Gender Affirming Evaluations and Referrals for hormones and surgery (service not covered by insurance, you may pay using your HSA or FSA card, cash, check, or credit card. Payment is required when the appointment is made).
  • Asylum Immigration Evaluations for Provisional Waivers (service not covered by insurance, you may pay using your HSA or FSA card, cash, check, or credit card. Payment is required when the appointment is made).
  • Duke Integrative Health Coaching: Achieve Your Wellness Goals
  • Presenting Engagements (fees vary).

Medicare:

  • AARP Medicare Complete through UnitedHealthcare
  • Oxford Medicare Network
  • Aetna Medicare
  • Central States of Omaha Medicare
  • HealthTeam Advantage Medicare
  • NC Medicare Part B
  • UnitedHealthcare Medicare Solutions
  • UnitedHealthcare Group Medicare Advantage

Military:

  • CHAMPVA
  • Military OneSource MOS EAP (pre-authorization is required)
  • Optum – Veterans Affairs Community Care Network (CCN) Regions 1-3 (pre-authorization is required)
  • Tricare East
  • Tricare for Life
  • Tricare West
  • TriWest Healthcare Alliance PC3/VCP REGIONS 3 and 4​(pre-authorization is required)
  • VA Fee Basis Programs (pre-authorization is required)

EAP:
(Requires Pre-Authorization from carrier prior to being scheduled):

    • Aetna EAP
    • Beacon EAP
    • CAREBRIDGE EAP
    • CONCERN EAP
    • CuraLinc Healthcare EAP
    • Health Advocate BCBS EAP
    • Humana EAP and Work-Life
    • Managed Health Network EAP
    • Mutual of Omaha EAP
    • New Directions EAP
    • Quantum Health Solutions EAP
    • UnitedHealthCare/Optum EAP

Letters & Forms

Charges are based upon the amount of time spent by Dr. Shaw in completion of the requested paperwork at the rate of $150/hour. Your forms will not be returned to you until payment is received.  If you cannot afford this cost, we recommend scheduling an office visit with Dr. Shaw for the sole purpose of form completion DURING the visit with the goal of limiting your out-of-pocket costs to your usual office visit insurance co-pay. Often forms can be completed more quickly when the patient is present to volunteer any necessary information. However, this leaves no additional time to discuss medical concerns, offer medical advice, place orders, or refill medications so please plan to make a separate visit for any other needs beyond form completion.  If the form cannot be completed during the 20 minute visit time. (We STRONGLY encourage you to consider a telehealth visit if this is your need.  However, it is necessary that you have had the form faxed, emailed, or uploaded to the patient portal more than 24 hours in advance.)

FMLA: $50 per form or $150/hour of Dr

It is mandatory that you have had a recent visit with Dr. Shaw to discuss the medical issue for which you need the form.  If you have an office visit with the SOLE PURPOSE of form completion

Disability Form: $50 per form or $150/hour

It is mandatory that you have had a recent visit with Dr. Shaw to discuss the medical issue for which you need the form.  If you have an office visit with the SOLE PURPOSE of form completion

Disability Support Letters: $150/hour

Only available to long-term established patients of Dr. Shaw who have ensured that she has access to all prior medical records and medical consultant records and may be declined at the clinical discretion of Dr. Shaw if we do not have the information and/or expertise to provide a strong supportive letter.

DMV Medical Review Form: $100 (Does not include a handicapped placard.)

Only available to established patients.

Biometric screenings, student health forms, NC teacher employment forms, employer health wellness forms: $10.  This cost is waived if form is completed during a visit/CPE. 

Other letters and forms requested that are not included on this list: $150/hour