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Locations
Lackawanna County
Blakely PA
Carbondale PA
Clarks Summit PA
Moosic PA
Downtown Scranton PA
North Scranton PA
Pike County
Matamoras PA
Northampton County
Bethlehem PA
Columbia County
Berwick PA
Luzerne County
Wilkes-Barre, PA
Kingston PA
West Pittston PA
Wyoming County
Tunkhannock PA
Montour County
Bloomsburg PA
Danville PA
Contact
570.961.3361
Home
Our practice
Administrative Staff
Therapists
Job Opportunities
Counseling Services
Telehealth
Careers
FAQs
Media
Locations
Lackawanna County
Blakely PA
Carbondale PA
Clarks Summit PA
Moosic PA
Downtown Scranton PA
North Scranton PA
Pike County
Matamoras PA
Northampton County
Bethlehem PA
Columbia County
Berwick PA
Luzerne County
Wilkes-Barre, PA
Kingston PA
West Pittston PA
Wyoming County
Tunkhannock PA
Montour County
Bloomsburg PA
Danville PA
Contact
✕
Home
Our practice
Administrative Staff
Therapists
Job Opportunities
Counseling Services
Telehealth
Careers
FAQs
Media
Locations
Lackawanna County
Blakely PA
Carbondale PA
Clarks Summit PA
Moosic PA
Downtown Scranton PA
North Scranton PA
Pike County
Matamoras PA
Northampton County
Bethlehem PA
Columbia County
Berwick PA
Luzerne County
Wilkes-Barre, PA
Kingston PA
West Pittston PA
Wyoming County
Tunkhannock PA
Montour County
Bloomsburg PA
Danville PA
Contact
Employee Assistance Plan Information
Employee Assistance Program
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EAP Name
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Number of Approved Sessions
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Please enter the number of sessions your EAP has approved you to have here.
Authorization Number
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This is the number you will get from your EAP that allows us to bill for your covered sessions.
Start Date
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This is the earliest you can have a session covered by your EAP
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End Date
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This is when your EAP benefits will expire, the last date you can have a covered session.
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Please also bring any forms or paperwork from your EAP to your first session. If you have any questions or are missing any of the information we need above, please contact us at 570-521-4637!
Consent
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Although this office will process claims by billing insurance companies, I understand that payment for insurance deductibles and co-pays are my responsibility. We do not impose any charge for no-show/late cancellation appointments, nor do we use collection agencies for outstanding late payments. By signing below, I give permission for submission to my Employee Assistance Company.
I agree to the payment policy.
Consent
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I understand my privacy and the Protected Health Information in the HIPAA information provided and available. I understand billing information (i.e. diagnosis) may be shared with others who need to arrange payment for my treatment by a third party payer (insurance companies / Employee Assistance Programs). This office uses the professional billing services of Mental Health Billing Services, LLC. I understand that if I am concerned about shared information, I have the right to ask for and receive further explanation.
Notice of Privacy and HIPPA
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