phone210-616-0300

rates, insurance & financial aid

are you covered?

Don’t let financial concerns keep you from seeking help. As a nonprofit organization, Clarity Child Guidance Center’s vision is to ensure that every child and family that needs our services receives our services.

Our financial representatives will work with you to find a way to get the help you need. We accept commercial insurances, CHIP, TRICARE, Medicaid, and also have many alternative methods to fund a child’s treatment. We have listed the insurances we currently accept below under payment for services.

our rates

outpatient rates

Master’s Level Clinician – $168/hour

Psychological Testing – $183.75/hour; Ph.D. – $189/hour; Total charges per case – $756 to $2,268

First Step – $183.75/hour; Ph.D. – $189/hour; Total charges per case – $378

facility rates per day

Acute – $2,160

Observation – $1947.75

PHP – $935

additional information

what to bring on your first visit

Please bring your insurance card. Also, check your plan to verify our participation and to confirm referral and co-pay requirements. If you are a member of an HMO or PPO requiring a referral, please either have the referral letter sent to us in advance of your visit, or bring a copy with you to your appointment.

In the event of an emergency, we understand you may not have these documents available.

payment for services

We will verify your insurance benefits, obtain any pre-certification necessary, and file your insurance claims. You will be required to make payment on any co-pay, deductible, or non-covered service at the time of your visit. We accept cash, checks, Visa, MasterCard, Discover, and American Express.

We comply with the privacy requirements of the Health Insurance Portability and Accountability Act (HIPAA). Therefore, all information in your record is strictly confidential and will not be released to anyone without your prior written approval.

We have contracts with the following organizations:

  • Aetna
  • Blue Cross/Blue Shield of Texas
  • Camino Real
  • Community MHMR Center
  • Center for Health Care Services (CHCS)
  • Community First Health Plan
  • ComPsych
  • Hill Country MHDD Centers
  • Magellan Health Services – (Summit Network, Medicaid and CHIP)
  • Medicaid / TMHP
  • Mental Health Network (MHN)
  • MercyCare Health Plans
  • MHNet Behavioral Health
  • United Healthcare
  • Private Healthcare Systems (PHCS)
  • Superior Health Plan
  • TRICARE
  • United Behavioral Health / Optum Health

financial assistance policy

Eligibility
Clarity Child Guidance Center (“Clarity”) offers free or reduced-priced medical care for all psychiatric emergencies or other medically necessary care for individuals eligible under our Financial Assistance Policy (“FAP”). Eligibility is based on Clarity’s Financial Assistance Policy, which includes using the Federal Poverty Guidelines, number of dependents, and gross annual income along with supporting income documents.

Additional means of determining eligibility may be utilized by the hospital if individual circumstances support that a completed application is not practical. Any third party resource that may be available to the patient must be applied for and used or demonstrate denial before assistance is approved by the Hospital.

This policy shall cover the provision of Financial Assistance and Charity Care for individuals who reside in the local CCGC Service Area and are unable to pay all or part of their medical bills. Individuals residing outside the local service area may be eligible by exception.

This policy does not apply to services that are not medically necessary or provided by physicians who are not employed by Clarity or Southwest Psychiatric Physicians (SPP).

Income guidelines
Patients eligible for Clarity’s Financial Assistance will not be charged more than the amount generally billed for psychiatric emergencies or other medically necessary care. Clarity uses the Look Back method with the amount being the Medicaid Fee-For-Service amount that Clarity would receive if the FAP-eligible individual were a Medicaid beneficiary. It is calculated each November and used for the following 12-month period. The detail of this information is available upon request by calling Clarity’s Patient Financial Services office at 210-593-2240.

If meeting Clarity’s FAP requirements, patients with income from all sources up to 100% of current Federal Poverty Guidelines may qualify for a 100% discount of their services rendered. Patients with income from all sources, greater than 100% of current Federal Poverty Guidelines, and up to 500% of Federal Poverty Guidelines may qualify for discounts between 55% and 100% of their service rendered. Medically indigent patients, a family whose hospital bill after payment by all third-party payers exceeds 10% of the household’s annual gross income may qualify for discounts up to 80% of their Hospital service. Household income exceeding 500% of Federal Poverty Guidelines will be considered for discounts if they would qualify for Medical Indigence under the Financial Assistance Policy or take advantage of any prompt pay discounts that may be offered.

Collection procedures
Normal collection procedures will be followed for all patients unless Clarity’s Financial Assistance Application Form is completed and submitted in a timely manner. Patients with incomplete applications will receive written notification identifying the additional information and the final date information or payment must be received to prevent submission of account to an outside agency for collection. Clarity’s detailed Collection Policy is available on the website listed below or upon request.

Information on Obtaining the Hospital Financial Assistance Application Forms and Policies

Additional information, along with the Hospital Financial Application, full detailed Financial Assistance Policy, and Collections Actions, a summary of the Financial Assistance Policy, Clarity Child Guidance Center Service Area, and an example of discounts under the Federal Poverty Guidelines are available.

Click on the links below to obtain the information:

Financial Assistance Policy Summary and Collection Procedures

Financial Assistance Policy

Financial Assistance Application Form

Financial Responsibility Form

An example of discounts under the Federal Poverty Guidelines

The forms and policies listed are printable PDF versions, and also available in Spanish.

Hospital methods of providing the hospital financial assistance application form
Paper copies of all of Clarity’s Financial Assistance Forms may be obtained in person from Clarity’s Patient Financial Services office at 8535 Tom Slick, San Antonio, TX 78229. Forms will be mailed to you at no cost by calling the Business Office at 210-593-2240. You may also obtain these forms by following the instructions in the above paragraph with the web site links. Our forms are available in English or Spanish and we do have other language assistance resources upon request.

Questions and assistance in completion of financial assistance application form
For further questions or assistance in the completion of the Financial Assistance Application, please call our Patient Financial Services office at 210-593-2240. You may also request a summary or complete copy of our Financial Assistance Policy from any Patient Financial Services employee, by calling 210-593-2240 or requesting the policy in writing to: Clarity CGC – Financial Assistance, 8535 Tom Slick, San Antonio, TX 78229.

Updated January 8, 2020

política de ayuda financiera

Elegibilidad
Clarity Child Guidance Center (“Clarity”) ofrece atención médica gratuita o a precio reducido para todas las emergencias psiquiátricas u otros servicios médicamente necesarios para las personas elegibles de acuerdo con nuestra Política de Ayuda Financiera (Financial Assistance Policy, FAP). La elegibilidad se basa en la política de ayuda financiera de Clarity, que incluye las Directrices Federales de Pobreza, el número de dependientes, y los ingresos anuales brutos junto con los correspondientes comprobantes de ingresos. el hospital puede utilizar otros medios para determinar la elegibilidad si las circunstancias individuales demuestran que no es práctico decidir solo con base a una solicitud. Cualquier recurso de terceros que pudiera estar disponible para el paciente, se debe solicitar y utilizar, o demostrar que fue negado, antes de que el hospital apruebe cualquier ayuda financiera. Esta política no se aplica a los servicios que no sean médicamente necesarios, o que sean proporcionados por médicos que no son empleados de Clarity o de Southwest Psychiatric Physicians (SPP).

Guía de ingresos
A los pacientes elegibles para recibir ayuda financiera de Clarity, no se les cobrará más del importe que se cobra generalmente por emergencias psiquiátricas u otros cuidados médicamente necesarios. Clarity utiliza el método de Look Back si la cantidad que Clarity recibe es la misma que la cantidad fija que Medicaid paga por el mismo servicio (Medicaid Fee-For-Service), y que Clarity recibiría si la persona elegible para FAP fuera beneficiaria de Medicaid. Se calcula cada noviembre y es utilizada para los siguientes 12 meses. El detalle de esta información está disponible, y la puede solicitar llamando a la oficina administrativa al 210-616-0300. Si el paciente cumple con los requisitos de la FAP de Clarity, y sus ingresos totales, de todas las fuentes, llegan al 100% de las Directrices Federales de Pobreza actuales, puede calificar para un descuento del 100% por los servicios recibidos. Los pacientes con ingresos totales, de todas las fuentes, que son superiores al 100% de las Directrices Federales de Pobreza actuales, y hasta el 500% de la línea federal de pobreza, podrán beneficiarse de descuentos entre el 55% y el 100% por los servicios recibidos. Los pacientes médicamente indigentes, como una familia cuya deuda con el hospital supera el 10% del ingreso bruto anual de la familia, después de todos los pagos por terceros, podrán beneficiarse de descuentos de hasta el 80% de su factura hospitalaria. Las familias con ingresos familiares superiores al 500% de la línea federal de pobreza, serán consideradas para descuentos si son elegibles para la indigencia médica según la política de ayuda financiera, o podrán tomar ventaja de los descuentos por pronto pago que se le puedan ofrecer.

Procedimientos de cobro
Los procedimientos normales de cobro serán aplicados a todos los pacientes, a menos que el formulario de solicitud de ayuda financiera de Clarity sea completado y presentado en el plazo debido. Los pacientes con solicitudes incompletas recibirán una carta solicitando información adicional e informando de la fecha límite para recibir la información o el pago, para evitar que la cuenta sea enviada a una agencia de cobranzas externa. La política de cobranza detallada de Clarity está disponible en el sitio web que aparece a continuación, o se puede solicitar por teléfono o en persona.

Para recibir la solicitud de ayuda financiera y las políticas del hospital:
Haga clic en los enlaces de abajo para ver los siguientes recursos adicionales:

  • Política de Ayuda Financiera
  • Solicitud de Ayuda Financiera
  • Política de Ayuda Financiera y Política de Cobranza de Clarity Child Guidance Center
  • Area de Servicio de Clarity Child Guidance Center
  • Ejemplo de descuentos según las Directrices Federales de Pobreza

Los formularios y las políticas mencionadas están en formato PDF y se pueden imprimir; también están disponibles en español.

Otro método para obtener la solicitud de ayuda financiera del hospital:
También puede obtener todos los formularios de ayuda financiera de Clarity si se presenta en la oficina administrativa en 8535 Tom Slick, San Antonio, TX 78229. Se le puede enviar la solicitud por correo sin costo para usted, llamando a la oficina administrativa al 210-616-0300. También puede obtener estos formularios siguiendo las instrucciones del párrafo anterior para los enlaces del sitio web. Nuestros formularios están disponibles en inglés y español y tenemos recursos de asistencia en otros idiomas, a petición.

Preguntas y ayuda para llenar la solicitud de ayuda financiera
Si tiene más preguntas o necesita ayuda para llenar la solicitud de ayuda financiera, por favor llame a nuestra oficina al 210-616-0300. También puede solicitar un resumen o una copia completa de nuestra política de ayuda financiera a cualquier empleado de la oficina administrativa, llamando al 210-616-0300 o puede solicitar la política por escrito a: Clarity CGC – Ayuda financiera, 8535 Tom Slick, San Antonio, TX 78229.

your rights and protections against surprise medical bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

you are protected from balance billing for:

Emergency services
If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Texas law protects patients with state-regulated health insurance (about 16 percent of Texans) from surprise medical bills in emergencies or when they didn’t have a choice of doctors. The law bans doctors and providers from sending surprise medical bills to patients in those cases.

Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible. pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

Texas law also prohibits balance billing for any health care, medical service or supply provided at an in-network facility by an out-of-network physician or other provider and for services by diagnostic imaging providers and laboratory service providers provided in connection with a health care service performed by a network physician or provider.

you’re never required to give up your protections from balance billing. you also aren’t required to get out-of-network care. you can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:

You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.

Generally, your health plan must:

  • Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

download standard pricing machine-readable file and shoppable services

Download Standard Pricing Machine-Readable File

Download Shoppable Services Pricing

The list is a comprehensive list of the services provided by Clarity Child Guidance Center.

organized health care arrangements

Clarity Child Guidance Center participates in an Organized Health Care Arrangement (OHCA) with other healthcare providers. Within the OHCA, member organizations may share your health information for treatment, payment, or operations related to the OHCA. Here is a list of Clarity’s current OHCA participants:

Southwest Psychiatric Physicians
8535 Tom Slick Dr., Bldg. 1
San Antonio, TX 78229
210-582-6440

The University of Texas Health Science Center at San Antonio
School of Medicine
7703 Floyd Curl Drive
San Antonio, TX 78229
210-567-7000

Southwest Texas Regional Advisory Council (STRAC)
7500 US-90 #1
San Antonio, TX 78227
210-233-5850