Financial Policy & Deposit Agreement
This Financial Policy is the Terms of Service referenced at checkout.
Vista Mental Health is in-network with HealthChoice (Oklahoma). Visits with any other insurance plan are self-pay. Part 1 applies to all patients. Please also read the part that applies to you (Part 2 for HealthChoice members, Part 3 for self-pay patients).
Part 1: Deposit, card on file, and missed visits (all patients)
Deposit for new patients
• A $25 deposit is required from every new patient to hold your initial evaluation, however you book. Your appointment is not confirmed until the deposit is paid. For HealthChoice members, the deposit is $25 or your estimated cost for the visit, whichever is less.
• After you book, you will receive a secure payment link by text message and by email (from info@vistamentalhealth.us). Your booking platform does not collect the deposit.
• Please pay within 24 hours of receiving the link (within 4 hours if your appointment is less than 48 hours away). If the deposit has not been received by then, your time slot may be released to another patient.
• The deposit is credited toward your visit. For self-pay patients, it is credited toward your initial evaluation fee. For HealthChoice members, it is credited toward your copay, deductible, and coinsurance.
Card on file
• The card you use to pay your deposit is saved securely for future charges. Existing patients will be asked to place a card on file before their next visit.
• By agreeing below, you authorize Vista Mental Health to charge your card on file for (1) any late cancellation or missed appointment fee described in this policy, (2) for HealthChoice members, any remaining copay, deductible, and coinsurance amount your plan says you owe, and (3) any other balance you owe under this policy. We will email you a receipt for each charge.
Cancellations and missed visits
• Please cancel or reschedule at least 24 hours before your appointment so we can offer the time to another patient.
• If you cancel or reschedule at least 24 hours before your appointment, your deposit is refunded in full (or moved to your new appointment time).
• If you cancel or reschedule with less than 24 hours notice, or miss your appointment, a $100 fee applies. The fee is the same for every patient and every type of appointment, including HealthChoice members.
• Your deposit, if you paid one, is applied to the fee first, and the rest of the $100 is charged to your card on file. For example, after a $25 deposit, $75 is charged. For visits with no deposit, the full $100 is charged.
• We may waive the fee in an emergency or other unavoidable circumstance. Please contact us as soon as you can.
• Unpaid fees must be paid before you can schedule another appointment. If you repeatedly miss appointments without 24 hours notice, we may be unable to schedule further visits, and we will help you find other care.
Payment at your visit
• The amount due for your visit (your estimated cost for HealthChoice members, or your remaining balance for self-pay patients) is due at the start of your appointment by credit or debit card. If your payment cannot be collected, we may reschedule your visit, and the visit will be treated as a late cancellation.
Part 2: HealthChoice members
How billing works
What you pay
• Your plan’s copay, plus your estimated deductible and coinsurance, is due at the time of your visit by credit or debit card. We calculate the estimate from your plan’s benefits. Amounts depend on your plan, so please check your mental health and telehealth benefits with HealthChoice before your visit.
• After HealthChoice processes your claim, we compare your estimate to the amount your plan assigns to you. If you paid too much, including through your deposit, we will refund the difference within 30 days. If you paid too little, we will bill you the remainder.
• If HealthChoice determines that a service is not covered by your plan, you are responsible for that service at our self-pay fee.
• The late cancellation and missed appointment fee in Part 1 is charged to you directly. We do not bill HealthChoice for it.
Part 3: Self-pay (all other patients)
We are not in network with your plan and cannot bill your insurance for these visits. You may submit your receipt to your insurer for possible out-of-network reimbursement.
Fees
Initial Evaluation (60 minutes): $300
Follow-up visit (20 minutes): $150
Deposit and balance
• Your $25 deposit (see Part 1) is credited toward your $300 initial evaluation fee, so the remaining balance at your visit is $275.
• Remaining balances are due at the time of your visit by credit or debit card.
• Follow-up visits do not require a deposit. Follow-up visits canceled or rescheduled with less than 24 hours notice, or missed, are charged the $100 fee described in Part 1.
Agreement
By checking the agreement box at checkout and paying your deposit, you agree to this Financial Policy, including the card-on-file authorization in Part 1. Part 1 applies to all patients. Part 2 also applies if you are a HealthChoice member, and Part 3 also applies if you are a self-pay patient.
• We bill HealthChoice for your covered visits. For your initial evaluation, a deposit applies as described in Part 1, and it is credited toward the amount you owe.
• Please enter your HealthChoice information accurately when you book. We verify your coverage before your first visit.
• If we cannot verify active HealthChoice coverage, your visit is self-pay and Part 3 applies.