RESOURCES

Below are useful resources to navigate our Practice and our Services including our Patient Ally Portal log on link, instructional video, and FAQs. Access to our Forms as well as when and how to use them, in-network insurance companies in which we participate, self-pay options, other fees, our policies, and some supportive videos are also located here.

Didn’t find what you needed? Call our Patient Care Team, available Monday through Friday from 8:00 am to 5:00 pm at 850-389-8489, or submit a request for a team member to call you by clicking the button below and completing the online form.

SUBMIT YOUR REQUEST

Patient Portal


We have partnered with Patient Ally to provide a free, secure, confidential, and easy to use patient portal that enables our Clinical Team and Patient Care Team members to connect with our patients. Current and new patients can register, log in, and access messages as well as important documents regarding their services and treatment. While Patient Ally offers a variety of tools for patients to access and manage their personal health records, we are currently employing the messaging and documents features and will add more facets in the future.

Have questions? You can watch the quick 4-minute tutorial video below. Also, you can scroll down for answers to frequently asked questions. Need more help? Please contact Patient Ally at 1-888-747-4255, via email, info@patientally.com or review the information at patientally.com/welcome.

 
 
  • To access Patient Ally’s patient portal, you must first receive an email initiated by our office, but will be from Office Ally Patient Ally. If you do not see the email, please check your spam folder in case the invitation email was accidentally put there versus your inbox.

  • Please call our office, 850-389-8489, and our Patient Care Team will send another email invitation for you to enroll. Keep in mind, all email invitations have an expiration date for security purposes.

  • You will need 1) a valid email in which you would like to receive notifications and 2) a valid phone number that you can link to your account to receive a verification code you can get via text message or phone call. Your username will need to be a minimum of 5 characters and your password will need to be at least 6 characters.

  • Unfortunately, no, you cannot change your username at this time.

  • If you have set up your Patient Ally account with a valid email, click here and you will be directed to the Patient Ally log on screen. You’ll need your username and password.

  • If you do not remember your username, you can click on the Help button on the Patient Ally log on screen then select Recover Username. Follow the instructions on the screen, complete the form, and your username will be emailed to you.

  • If you do not remember your password, you can click on the Help button on the Patient Ally log on screen then select Recover Password. Follow the instructions on the screen, complete the form, and select how you would like to receive the verification code needed to reset your password (email, text SMS, or voice call).

  • In order to add a provider to your Patient Ally account, the provider must invite you as a connection if you have another practice or facility that also uses Patient Ally and you are already currently enrolled.

  • If you do not see your provider listed in a certain feature of Patient Ally, the provider and/or practice has not chosen to utilize or support that feature.

  • Patient Ally can be used on multiple browsers including Internet Explorer 11, Chrome, Firefox, and Safari.

  • We recommend you use caution and appropriate internet safety measures when accessing your information. While our Patient Ally patient portal is secure, it is your responsibility to insure your email address and account is private and no one else has access. Do not use public wifi, or connections you do not trust, and avoid logging in via public, shared computers or other devices where your login details or private information could be compromised. As with any other password, do not share your Patient Ally password with anyone.

  • If you need more help with the Patient Ally system, please contact Patient Ally Technical Support at 1-888-747-4255 or via email, info@patientally.com

Forms


New Patient Registration

Our Practice registration and fillable forms are sent (with an email notification) to patients once enrolled in Patient Ally, our practice management system’s patient portal. You can also download and complete your New Patient Information and the appropriate History form using the buttons below.

Fill Out Online

These digital fillable forms can be completed in your browser, by using Adobe Acrobat, or by using another PDF viewer, then printed, signed, and submitted to our Patient Care Team before your first appointment. If you complete forms within your browser, you must save it as a PDF and print directly from your browser in order to maintain your responses. We suggest using Google Chrome to complete and print your registration before adding your signature.

Print & Sign

If you prefer to complete all documents in paper form, please print the blank forms, completing them by hand including your signature, and submit them to our Patient Care Team. We require your registration documents be completed and submitted to our Team before an appointment will be scheduled.  


New Patient Information
Adult History (Ages 19+)
Child/Teen History (Ages 1-18)
Supplemental Psychiatric Treatment Informed Consent
Authorization to Release Confidential Information

Insurance & Self-Pay Options


Insurance

We are in-network with:

  • Aetna ASA PPO

  • All Savers

  • CHAMPVA

  • GEHA (Government Employees Health Association)

  • Meritain Health

  • Optum

  • TRICARE East Prime

  • TRICARE East Select

  • UBH (United Behavioral Health)

  • UHC (United Health Care)

  • UMR (United Medical Review)

  • VA CCN (Veterans Affairs Community Care Network-Optum & TriWest Healthcare Alliance)

  • WebTPA

Fees

Please see our detailed Service & Fee Schedule below.

Deductibles, co-insurance, shared costs, co-pays, and/or self-pay fees are due at the time of service and payment method is solidified during registration.

Self-Pay

Rather pay for your treatment directly and not use health insurance? In most cases, we can supply a superbill and/or visit statement (an itemized detail of services provided) which you can submit to your insurance company.

Many Insurance companies and policies explicitly exclude psychological or psychoeducational testing for learning disabilities because it is often considered an educational problem rather than a medical issue. Evaluations for the purpose of academic placement, job placement, or general screening without specific symptoms linked to a medical necessity require self-payment. Please call our office for inquiries related to specific learning disorders (SLD) with impairment in reading (dyslexia), with impairment in written expression (dysgraphia), with impairment in mathematics (dyscalculia), or other academic-related testing such as giftedness or intellectual assessments. Additionally, evaluations for ADHD require detailed medical necessity rationale to be performed and covered by most insurance companies or will be self-pay.

Services & Fee Schedule

  • Diagnostic Evaluation, Initial Intake Assessment - $275

  • 55 minute appointment with psychiatric prescribing Provider - $275

  • 30 minute appointment with psychiatric prescribing Provider - $200

  • 55 minute session with mental health Provider - $225

  • 45 minute session with mental health Provider - $200

  • 30 minute session with mental health Provider - $150

  • Telephone consultations (charged at 15-minute increments) - $200/hour

  • Records review (charged at 15-minute increments) - $200/hour

  • Letter writing & form/document completion - $50/first page, $25 each page after

  • No show & late cancellation - $100

  • Returned check - $50

  • Records request (FL Administrative Code Rule 64B8-10.003) - $1.00/first 25 pages, $0.25 each page after

  • Legal and court, retainer paid minimum one week in advance - $2,000/retainer, $500/hour + any and all other costs incurred as result of the legal action

  • For more information on the No Surprise Act of 2022 - https://www.cms.gov/nosurprises

  • For Good Faith Estimates - Ask our Patient Care Team Members

Policies & Helpful Videos

In addition to the forms and information above, you can review our Practice policies and watch some short, helpful videos from our PsychHub partner.

Privacy Policy
Internet & Online Policy
Collateral Visits Q&As
Dear Soon-to-be young adult patient
What Parents/Guardians Need to Know When Their Child Turns 18 Years Old

Let us know how
we can help.

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