Financial Policy

We want billing arrangements to be as straightforward as possible

Services provided by the Children’s Program are billed on an hourly basis. Charges are submitted under the client’s name. If a child is the client, billing is submitted under the child’s name.

Medical and Psychological services provided at the Children’s Program may be covered under the mental health benefits of your health insurance contract. Extended phone calls, follow-up correspondence, and out-of-the office consultation cannot be billed to health insurance.

Speech and Language services insurance coverage vary greatly. It is your responsibility to understand these insurance benefits before your visits occur. We cannot guarantee services will be covered/paid for by your plan. Educational services are not health insurance covered. We do not submit claims for these visits. As of January 1st, 2024 we no longer directly bill for Speech and Language services.

Our office maintains a direct billing relationship with many, but not all, health insurance companies (click here for insurance information).

It is important for families to educate themselves about the mental health benefits of their health insurance policies. Determine if your company provides a managed mental health benefit, whether you must meet a deductible, the amount of your copayment/coinsurance, and whether pre-authorization is required. In most cases pre-authorization is initiated by the family/client and NOT the primary care physician/pediatrician. Coverage is limited for specific diagnoses e.g. Attention Deficit, Autism Spectrum, or for particular services, e.g., psychological testing, family therapy.

We will do our best to inform you of your financial obligation when scheduling your appointment. When a child is the client, the parent/guardian seeking services is responsible for the account. A Child Information form and a Consent for Healthcare Operations form must be completed prior to your first appointment. A credit card must be maintained on file. Credit card information is maintained in StoredPay, a service that allows your client payment information to be securely stored on file with the Children’s Program payment service, BillFlash. All payments incur a $1 administrative fee.

If we are NOT contracted to bill your health insurance, payment in full is due at the time of the appointment. Fees are collected on the day of your appointment. Families using an out-of-network benefit can request copies of fee slips and a guide for self-billing insurance.

If we are billing your primary/secondary health insurance company we will attempt to gather information about your mental health benefits.

However, this information does not guarantee payment. The agreement with your insurance carrier is a contract between you, your insurance company and, in some cases, your employer. Please remember, billing insurance is not a guarantee of payment. If your insurance plan does not cover a service, a procedure, or a diagnosis, you are responsible for these charges. A credit card must be maintained on file. Your financial responsibility for your visit, whether it is a deductible, copayment/co-insurance, will be charged to this credit card on the day of your appointment.

Financial arrangements between divorced parents must be handled independently of the Children’s Program. In cases of divorce, the parent seeking service is responsible for the account and must sign the Consent for Healthcare Operations form. If the other parent holds the insurance, they, too, must sign a Consent for Payment and Healthcare Operations form. This gives us permission to bill the health insurance. Fees due on the day of an appointment must be collected at every visit regardless of who brings a child to the appointment.

We will bill a client’s insurance carrier if we are provided current and correct information. Our policy is to allow insurance carriers 60 days to pay a claim. Please notify us prior to your next appointment if you have a change in insurance. Any claims past 30 days that have been requested to be re-billed to a different insurance company than what we have on file will be subject to a $50 re-billing fee. All updates to insurance can be made online through our website.

Accounts unpaid after 60 days will be assessed a re-billing charge. If a payment has not been received from an insurance company within 60 days, we encourage the client to work actively with the insurance company to secure payment. Accounts with unpaid balances after 90 days will be referred for collection action. To avoid collection action and re-billing charges you will be contacted to use your credit card number. This will be kept on file and can be used to settle the balance. We make every attempt to contact you prior to charging an unpaid balance.

Please call our Billing Office at (503) 452-8002 (Option 3 for billing) or (503) 452-0307 if you need a printout of your account or to answer any questions.

In the event of non-payment of charges, the Children’s Program shall be entitled to recover all costs and expenses incurred in seeking collection of such charges, including, without limitation, court costs and reasonable attorney’s fees, whether such claims are pursued through court proceedings, appellate or bankruptcy proceedings, arbitration, and/or mediation.

Please note our cancellation policies outlined below.
      a) If you must cancel an evaluation appointment, please notify us at least 5 business days in advance.
We may elect not to reschedule evaluations canceled without sufficient notice. A mandatory fee up to 100% of the full charge may be assessed.
      b) To cancel a scheduled therapy appointment, please call during office hours and give at least 48 business hours advance notice.
A mandatory fee of up to 100% of the charge will be assessed for missed appointments or appointments cancelled without this notice.
      c) Cancellations left on voicemail after business hours will be considered received as of the next business day.
Reminder phone calls are not guaranteed.
      d) Cancelled appointments are not billable to insurance.


Click here to download a copy of this financial policy page.

Click here to download a copy of therapy group financial policy.

Privacy Policy

Updated 7/9/2024 

At the Children’s Program, we are committed to protecting the privacy and security of our clients’ personal information. We comply with all applicable privacy laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), to ensure that your Protected Health Information (PHI) is safeguarded. 
This Privacy Policy further details how we collect, use, disclose, and safeguard your information when you visit our clinic or use our services. Please read this policy carefully to understand our practices regarding your personal information. 

  1. Information We Collect

We may collect and process the following types of information: 

  • Personal Identification/Demographic Information: Name, date of birth, gender, address, phone number, email address, and other contact information. 
  • Health Information: Medical history, mental health assessments, treatment plans, therapy notes, and other health related information. 
  • Payment Information: Billing address, credit card information, insurance details, and other payment related information. 
  • Usage Information: Information about how you use our services, including appointment history and feedback. 
  1. How We Use Your Information

We use the information we collect for various purposes, including to: 

  • Provide, operate, and maintain our services. 
  • Manage your treatment and healthcare needs. 
  • Communicate with you, including sending appointment reminders and responding to inquiries. 
  • Process billing and insurance claims. 
  • Improve our services and develop new programs. 
  • Ensure the security and safety of our clinic and services. 
  • Comply with legal and regulatory requirements. 
  1. Disclosure of Your Information

We ONLY share your information in the following circumstances: 

  • With Healthcare Providers: To coordinate your care with other healthcare professionals and facilities. 
  • With Educators: To share evaluation reports with your child’s educators, with your express consent. 
  • With Third-Party Service Providers: To perform services on our behalf, such as billing, payment processing, and IT support. 
  • With Legal Authorities: To comply with legal obligations, such as court orders or subpoenas. 
  • With Your Consent: For other purposes with your express consent. 
  1. Data Security

We implement appropriate technical and organizational measures to protect your PHI from unauthorized access, disclosure, alteration, or destruction. These measures include encryption, secure storage, and access controls. 

  1. Retention of Your Information

We retain your personal information for as long as necessary to fulfill the purposes outlined in this Privacy Policy or as required by law. When your information is no longer needed, we will securely dispose of it. 

  1. Your Rights

You have certain rights regarding your personal information, including the right to: 

  •  Access your information and obtain a copy of it. 
  •  Request corrections to your information if it is inaccurate or incomplete. 
  •  Withdraw your consent to the use or disclosure of your information at any time. 

To exercise these rights, please contact us using the information provided below. 

  1. Changes to This Privacy Policy

We may update this Privacy Policy occasionally to reflect changes in our practices or for other operational, legal, or regulatory reasons. We will notify you of any significant changes by posting the new policy on our website and updating the effective date. 

  1. Contact Us

If you have any questions or concerns about this Privacy Policy or our privacy practices, please contact:  

Allan Cordova, Ph.D.
HIPAA Compliance Officer 
Children’s Program 
6443 SW Beaverton-Hillsdale Hwy, Suite 300 
Portland, OR 97221 


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