Forms and Fees

Find necessary forms you may need to fill out before your appointment and fees associated with your treatment.

Patient Registration

Items with a * are required.

Step 1 of 3

  • Patient Registration

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY

Prior Authorization Requests

Please Note:

  • Prior authorisations are required when your insurance company requires justification for why you need to take this medication.
  • Completing a request does not guarantee your insurance company will agree to pay for the medication. I will do my best to advocate for you. Should they deny coverage, your options then would be to pay out of pocket or change medications.
  • I will need up to date insurance information (including any of the following if you see it on your card: Plan Name/BIN/PCN/Rx Group). This will help ensure the correct form for your specific insurance is completed. If the wrong form is used, the PA would need to be redone and would delay a response.
  • Insurance companies generally have 5-7 days to reply.
  • I may need to correspond with you for information regarding previous trials of medications if the insurance company requires.
  • Please do not text me to let me know you have a prior authorisation request.
  • If you do not want to wait for a response from your insurance company, you can fill it out of pocket. Some insurances will retroactively reimburse you once a PA is completed. There is an app called GoodRx that will provide coupons to help offset the price.
  • Plan Name/BIN/PCN/Rx Group if is available. Please identify which one(s) you are inputting. You may enter “unknown” if the information is not available.
  • I understand prior authorisation requests may take 5-7 business days and completion of a request by Dr. Sood is not a guarantee that my insurance will cover this medication.
  • Neuroleptic (Antipsychotic) Medication Consent Form

  • MM slash DD slash YYYY

Fees for Treatment

Insurance Accepted

I do take most commercial insurances, as well as Medicare and Medicaid. It is your responsibility to ensure I am within network with your insurance. 

For commercial insurances, it is also your responsibility to see what your yearly deductible is and if you have met it. If you have not met your yearly deductible, then visits are out of pocket until deductible is met. My biller will apply it to your insurance.

Out of pocket fees

Initial Psychiatric Evaluation:  $350

Follow up appointments/Medication Management:  $125

Individual therapy: $350/hour

Second Opinion/One time consult:  $500

I accept cash, check, and credit card.

Cancellation Policy

I will generally text reminders of appointments 1-2 days prior to your appointment. You will also receive an email reminder about 1 week before the appointment from my medical records system (It will come from “PatientFusion”)

Appointments that are not cancelled within 24 hours prior to appointment or missed  (barring special situations) will be charged the full out of pocket charge. Insurance does not apply to this situation.

Make a Payment

Online

If you have received a bill for balances due after copayment and insurance payment, you may pay the balance online at myproviderlink.com

Click on “Guest Pay” and enter your account number shown on the top left of your payment statement.
The form ID needed is 22032162

Pay by Mail

If you wish to mail a check, please contact Dr. Sood for an address

NOTE: Please make checks payable to CHS PSYCHIATRIC ASSOCIATES

Billing Questions

If you have billing questions, please call 843-620-3770 or email sood@patientbill.net