At Norwood Behavioral Health (NBH), we request keeping your credit or debit card on file as a convenient method of payment for the portion of services that your insurance doesn’t cover, but for which you are liable, including missed appointment fees. We will mail or email the primary email on file a receipt when payment is collected.
Your credit card information is kept confidential and secure. Deductible, co-insurance, or other uncovered fees are processed after the claim has been filed and processed by your insurer, and the insurance portion of the claim has been paid and posted to the account. Payments for copayments are typically processed within 1-2 weeks of the time of service. We strongly recommend keeping a credit card on file.
Please only enter the last four digits of your credit card number on this form to identify the card you would like us to use. This form will not allow us to collect the entire card number for security purposes. We will be calling to confirm the entire card number.
I authorize NBH to charge the portion of my bill that is my financial responsibility to the following credit or debit card: