Registration Forms
First-time clients: Fill out each form below with the client information and email them to michellen@compasscounseling.info
Insurance
Compass Counseling accepts most HMO insurance plans, medical assistance (Badger Care), and self-pay.
To verify if Compass Counseling is in network with your insurance provider, please call the customer service number on the back of the insurance card.
Billing and Payments
Good Faith Estimate (GFE)
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.
Under the No Surprises Act, healthcare providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs. The estimate is based on information known at the time the estimate was created. The GFE is to be given both orally and in writing, upon request, or within 3 business days upon request. Information regarding scheduled items and services must be furnished within 1 business day of scheduling an item or service to be provided in 3 business days and within 3 business days of scheduling an item or service to be provided in at least 10 business days.
Privacy Policy
Compass Counseling is required by law to maintain the privacy of your health information in accordance with federal and state law. This Notice of Privacy Practices ("Notice") outlines our legal duties and privacy practices with respect to health information. We are required by law to provide you with a copy of this Notice and to notify you following a breach of your unsecured health information.
We will abide by the terms of the Notice. We reserve the right to make changes to this Notice as permitted by law. We reserve the right to make the new Notice provisions effective for all health information we currently maintain, as well as any health information we receive in the future. If we make material or important changes to our privacy practices, we will promptly revise our Notice. Each version of the Notice will have an effective date listed on the first page. If we change this Notice, you can access the revised Notice on our website.