Fees
PAYMENT & INSURANCE: Payment (or co-pay) is due at the time of your appointment. Currently I am in-network provider for some but not all insurance. Please check with your insurance carrier. If I am not in your insurance network then full payment will be due at the time of your appointment. You have the option of submitting reimbursement forms directly to your insurance company or I can do it for you. Reimbursement levels change, please check with your insurance company for the current rates for your policy, if it covers out-of-network providers and mental health services.
Payment can be by check, cash or debit/credit card. There is a fee for returned checks.
Fee scale is adjustable for UNC students & employees.
Payment can be by check, cash or debit/credit card. There is a fee for returned checks.
Fee scale is adjustable for UNC students & employees.
Forms
Please download and review the following forms prior to our first visit.
| 3_demographic_client_info_form_noreen_esposito_pmhnp_2017.docx |
| 4_consent_for_treatment_fall_2017.docx |
| 2_ne_authorization_to_release_health_prof_and_meds_2017.docx |
| 7_client_things_to_work_on_.docx |
Appointments and Cancellation Policy.
An appointment represents time reserved personally for you. If you need to cancel or change your appointment it is important that you call me at least 24 hours in advance or a session fee will be charged. Cancellations must be made via phone call or voice mail, not through email correspondence. Note that your insurance company will not reimburse you for missed appointments, so you will be responsible for the entire charge of the reserved time. This policy ensures that another client in need of an appointment can be seen.