We’re glad you’ve chosen us, and we look forward to seeing you. When you come to our office for your first appointment, please bring the following: 

• Please complete online forms which will be emailed to you from our office. They are required to be filled and submitted at least 48 hours prior to your appointment.
• Insurance card
• Driver’s license or another acceptable form of ID, such as a passport or another state- or government-issued identification
• List of current medications (provided from your pharmacy)
• Past medical records (if possible)
• Discharge summaries from past hospitalizations (We can help you get this information.)
• Payment (cash, check, credit card); co-pays and fees for services are due at the time of service.

Adolescent/minor clients must be accompanied to the first session by an adult who has legal guardianship. This adult must be able to legally consent for the adolescent/minor client to receive services.

All payments, including co-pays, payment for services not covered by insurance, and payment for patients without insurance coverage are due at the time of service, unless alternative agreements have been made in advance.

Wellcore participates in network for BCBC/CareFirst, Cigna, and JHHC EHP USFHP. Wellcore does not participate in any Medical Assistance plans.

Patients can choose to file for reimbursement if their insurance company is not listed here. If we participate with your insurance company, you’ll just pay your copay once you’ve met your health plan’s annual deductible amount. If your insurance plan has an in-network requirement, it should cover most of the services we offer, and you should only be responsible for your copay. If you need to meet an annual deductible, your copays may be higher until the deductible is met. If you do not have insurance coverage or if Wellcore is considered out-of-network, contact us to discuss the fees.

Non-insurance charges are as follows:

• Initial Appointment $$275
• Follow up Appointment $175
• Late Cancellation/No-Show/Missed Appointment Fee $75 (We understand you may need to reschedule, but any cancellations with less than 24-hours’ notice will be charged.)

THIRD PARTY INSURANCE FORMS (DISABILITY, FMLA, ETC):    There is a $50 “per” form fee for completing any form that is not directly related to reimbursement of medical services.  For compliance purposes, the patient information portions of the form must be completed and signed prior to acceptance, along with payment.  Fees must be paid before forms will be completed.  Please allow 7 - 14 days for completion of the forms.  We cannot complete forms at the time of visit.

Please:

• Allow two weeks for the completion of any forms.
• Leave all sections to be completed by the healthcare provider blank. If you improperly complete a form, it may cause delays and / or we may request a new form from you. 
• Understand that if your short-term disability form does not include a signed medical release, you will be required to complete our Authorization to Use or Disclose Medical Information.
• Let us know if you would like your form faxed, mailed or picked up in person.
• Know that we will contact you when your paperwork is completed.

As you see by our Privacy Policy, it’s our goal to protect the confidentiality of your records, However, there may be times where we’ll be compelled by law to disclose your records or provide testimony. No information will be released without a client's written consent unless mandated or permitted by law. If a court order is received, you will be notified in writing.

Possible exceptions to confidentiality include but are not limited to:

• Child abuse/abuse of the elderly or disabled
• Duty to protect, which includes thoughts, plan, and/or intent to harm oneself or others (i.e. suicidal or homicidal)
• Court orders
• A negligence suit brought by the client against the treatment provider or the filing of a complaint with a licensing board or other state or federal regulatory authority
• Regulatory authorities in connection with their compliance or investigatory responsibilities
• Employees or agents of the practice for operational purposes
• Supervisor, if the treatment provider is under supervision