Attendance Policy

Thank you for choosing Sunbreak Therapy Services. We want to provide the best possible services to all of our patients. We will do our best to schedule appointments that meet your needs. Regular attendance is important to you/your child’s success. We ask that you follow the attendance policies outlined below:

Cancellations: Please call us at least 48 hours in advance to reschedule your appointment.

Patients must maintain at least an 90% attendance rate over a 12 week period, or risk losing their regular appointment slot.

“Non-emergency” cancellations require 48 hours notice and include vacations, pre-planned medical appointments, family events, parties, sports events, lack of babysitter or anything that is not designated as “emergency”. If less than 48 hours is given or the session is not rescheduled within a two week period, the patient will be charged a $50 fee. For OHP insured clients, this will count as a late cancellation. If patients have 2 late cancellations that are not rescheduled, they will be removed from the schedule.

“Emergency” cancellations are accepted only for illness (fever within the last 24 hours, strep, unidentified rash, diarrhea, vomiting, or any highly contagious illness), illness of a family member, or death in the family. Patient is required to reschedule this appointment within 2 weeks. If the session is not rescheduled within a two week period, the patient will be charged a $50 fee. This appointment is in addition to the regularly scheduled sessions. For OHP clients, if patients have 2 late cancellations that are not rescheduled, they will be removed from the schedule. In the event of an emergency, the patient still must call the clinic as soon as possible to reschedule the appointment.

If a patient does not show for a scheduled appointment, they will be charged a $50 no-show fee and services will be put on hold. For OHP clients, services will be put on hold.

Late for Appointments: If a patient is more than 10 minutes late for their appointment, we reserve the right to cancel the appointment and consider it a missed appointment. If a patient comes late, they will only be seen for the allotted scheduled time.  If a patient is late for their appointment for 3 or more sessions, we will put services on hold.

Clinician Cancellations: If the therapy provider is not able to attend the scheduled appointment, the patient will be contacted as soon as possible to reschedule with the same provider or a different provider. Please be sure that your office knows the best way to reach you. Every effort will be made to reschedule your appointment in a timely manner. 

Payment Policy

Families with Insurance

We are a preferred provider for Regence Blue Cross Blue Shield of Oregon, Moda, Cigna,Providence, Kaiser, PacificSource, and some OHP insurances. Sunbreak Therapy Services will bill these insurance companies for your sessions. For other insurances, we can bill for out-of-network benefits; however, you are responsible for the full payment at time of service. Please be advised that it is your responsibility to check your benefits. Most plans require a referral from your doctor prior to the first visit.

Self-Pay (no Superbill)

We offer a self-pay discount when insurance is not used. We require a card on file to be runfor each visit or pay by check/cash before the therapy session.

Returned Check Policy

Checks that are returned for insufficient funds will incur a $50.00 charge.

Attendance Policy

Every effort will be made to schedule a time convenient to your schedule. Notification of cancellation should be at least 24 hours prior to your appointment. We will make exceptions for sudden illness. A charge of $50.00 will be incurred for a missed appointment without notification. You are responsible for the charge. Insurance will not pay.

Credit Card on File Policy

Sunbreak Therapy Services requires a credit card on file. Your card will be charged at time of service for the patient's responsibility such as copays, deductibles, and co-insurance and any account balance after your insurance processes the claims. Your credit card information will be kept confidential and secure. My signature below indicates that I authorize Sunbreak Therapy Services to charge my credit card on file. Balances greater than $500 a statement will be emailed to you prior to your card being charged.

Non-Insurance Covered Fees

30 minute parent meeting, $75
15 minute parent meeting, $38
Form completion, $20 per form
IEP meetings, $150/hour plus travel fees

I have read these policies and understand that I am solely responsible for any charges incurred at Sunbreak Therapy Services. I give my written permission for Sunbreak Therapy Services to treat myself or my child and communicate with my insurance as necessary for billing and payments.

Acknowledgment That You Have Received Our HIPAA Privacy Notice

Sunbreak Speech, LLC is required by law to keep your health information safe. This information may include:

• Notes from your doctor, teacher, or other health care provider
• Your medical history
• Your tests results
• Treatment notes
• Insurance information

We are required by law to give you a copy of our privacy notice. This notice tells you how your health information may be used and shared. It also tells you how you can look at and comment on your information.

 

 

By signing this page, you are saying that you have been offered a copy of our privacy notice.

1. Confidentiality and Privacy:

• All therapy sessions are private and confidential. No unauthorized persons should enter or disturb the therapy
  space during sessions.
• Conversations and activities within therapy spaces must be kept confidential by all individuals present.

2. Respectful Behavior:

• All individuals must adhere to a standard of respect and professionalism in the therapy space. This includes maintaining a quiet and calm demeanor to support a focused therapeutic environment.
• Personal electronic devices should be silenced or turned off to avoid disruptions. Personal phone calls should be
  taken outside the building.

3. Hygiene and Maintenance:

• Sunbreak staff will not provide toileting assistance. Caregivers must be present for diapering and toileting needs.
• Clients may be subject to reimburse Sunbreak in the event of broken toys/materials/equipment, situationdependent.

4. Scheduled Sessions:

• Arrive promptly for appointments to ensure that sessions start and end on time, respecting the schedule of other clients and staff. Clients arriving more than 15 minutes late will not be seen.
• Caregivers should stay within 5 minutes of the property and return to the building with 5 minutes remaining in the treatment session.
• To ensure an effective and focused treatment environment, the presence of siblings in the treatment room is restricted

5. Interactions and Conduct:

• All interactions should be conducted in a manner that supports the therapeutic goals and respects the privacy of others.
• Threatening or assaultive behavior will not be tolerated.
• Photos and videos are not allowed without clinician permission.

6. Visitor Policy:

• Visitors or additional family members should remain in designated waiting areas unless prior permission is granted by the therapist or treatment team.
• Any special requests or needs related to visitor presence should be communicated to the therapy provider in advance.

7. Policy Enforcement:

• All staff members are responsible for enforcing this policy and addressing any breaches or issues.
• Individuals who do not adhere to this policy may be asked to leave the therapy space or reschedule their appointment.

8. Review and Updates:

• This policy will be reviewed and updated as needed to ensure it continues to meet the needs of the therapyenvironment and its participants.