Financial Policy & Billing Agreement

This Financial Policy & Billing Agreement (“Agreement”) governs all services requested, scheduled, arranged, facilitated, or received through First Fridays Health LLC, DBA SameDayPsych.com (“SameDayPsych,” “Company,” “we,” “us,” or “our”).

By checking an acceptance box, clicking “I agree,” creating an account, scheduling, or receiving services, you (“Patient,” “Responsible Party,” or “Guarantor”) agree to be legally bound. This constitutes your electronic signature.

1. Guaranty of Payment. You agree to be personally and fully responsible, as guarantor, for all charges, regardless of insurance status.
2. Agreement to Pay. You agree to pay all charges not prohibited by law, including deductibles, copayments, coinsurance, denied claims, non-covered services, and out-of-network charges.
3. Insurance Disclaimer. Insurance verification is not a guarantee of payment. You remain responsible for all balances.
4. Assignment of Benefits. You assign all insurance benefits to SameDayPsych and/or its providers. Payments received by you must be forwarded.
5. Payment Authorization. You authorize SameDayPsych to charge your payment method for all balances, including partial and recurring charges and retries.
6. Out-of-Network Services. You may be responsible for full charges except where prohibited by law.
7. Good Faith Estimate. You may request a Good Faith Estimate where required. Estimates are not guarantees.
8. Missed Appointments. Late cancellations and no-shows may be charged and are not billable to insurance.
9. Account Default. Balances may become immediately due upon default.
10. Collections. To the fullest extent permitted by law, SameDayPsych may pursue collections, including agencies, legal action, and recovery of costs.
11. Credit Reporting. SameDayPsych will not report medical debt where prohibited by law. Where permitted, reporting complies with FCRA and state law.
12. Interest and Fees. Interest and late fees may apply as permitted by law.
13. Disputes. Billing disputes must be submitted within 30 days.
14. Suspension. Non-emergency services may be suspended for nonpayment.
15. Communications. You consent to being contacted regarding billing via phone, email, text, or portal.
16. State-Specific Compliance. If your state law differs, it controls.

17. Limitation. SameDayPsych will not collect amounts or use methods prohibited by law.
18. Governing Law. California law governs except where federal or other state law applies.
19. Agreement. You acknowledge and accept full financial responsibility.