Welcome to Psych Atlanta, we are here to help during this difficult time!
Street Address Line 2
State / Province
Postal / Zip Code
Type of Treatment Sought
Medication Management Evaluation
Seeking Help For:
Type of Payment
Health Saving Account
Blue Cross Blue Shield/ Anthem
United Health Care
United Behavioral Health
Coventry Health Care
Is this a Medicare Policy?
Is your Blue Cross poilcy a Silver, Bronze or Gold Pathway policy?
We would love to serve you at Psych Atlanta, but unfortunately we are not in contract with your insurance carrier. One option you have is to become a self pay patient and file for out-of-network benefits with your carrier. You would enjoy a discounted follow-up rate of $135 per visit after the initial evaluation of $350. In reality, these rates are not much higher than out of pocket expenses for insurance users when they have a deductible that is not yet met. If you would like to pursue this option, please change the the above "Type of Payment" Option of “Self-Pay”. We will review your info and follow up with you. If you have already changed to "self-pay", please ignore this message.
Please enter the followng method/s of contact:
Current Mental Health Medication List
Help your doctor with your medication history by visiting www.pastmeds.com
If you are currently not on any medications, please check the box.
Are you interested in participating in a research study?
Any Other Information That May Be Helpful
Be sure and check your email or cell phone )(if you gave us that info) for a confirmation message after submitting!
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