New Client Registration

Please complete the following registration form. After submitting, a member of our team will connect with you to verify your treatment plan and provide your follow up schedule.

LMH Policies

Client Membership

Membership at LMH is established after completing both Initial Evaluation and new client registration. 

  • Both clinician and patient must consent to the continuation of treatment after initial evaluation in order to establish ongoing psychiatric or therapeutic treatment. 

    Upon becoming a client at Latitude Mental Health, you will work directly with our administrators to determine a day and time for your recurring appointments. 

    Sessions range between 45-75 minutes depending on desired treatment plan. 

    • The scheduled appointment times will be reserved for you, therefore, if you are unable to attend, you must provide 48 hours advance notice.

Scheduling

We are only able to reimburse the cost of a session if the appointment is canceled due to an emergency or special circumstance. Each session is meaningful and important so we ask that each member reschedules appointments rather than canceling. 

In the event of either an unforeseen emergency or special circumstance, it is the responsibility of the member to provide both notification and documentation to Latitude Mental Health as soon as possible.

  • If you miss a scheduled appointment, you will not be rescheduled. Instead, you will be deferred to a 15-minute clinical consultation. 

  • If you need to reschedule an appointment, please let us know at least 48 hours before your appointment and we will work with you to reschedule the appointment.

  • Any changes to your appointments must go through the administrative team.  You can let us know by email at admin@lmh.care or by texting/leaving a voicemail at (323) 609-5936.

Billing

All members receive a Superbill after their appointment. Superbills, also known as Statements for Insurance Reimbursement, are the receipt that follows the members appointment. They are not a charge on the members account, but are based off of a credit payment system. These receipts are to be sent to the members insurance company for a refund. We try to optimize our members' reimbursement to the highest level by providing this Superbill. If you have any questions, please reach out to our administrative team – we are happy to help.

  • You will have the option of providing payments on either a recurring biweekly or monthly basis, according to your desired treatment plan and frequency.

  • Payments are made automatically each month for your convenience. If a payment fails you will have 24 hours to resolve the payment. If payment is not resolved after 24 hours of receiving the initial reminder, you will be charged a penalty fee of $25. 

  • Any changes to your treatment plan should be discussed with your provider first. A formal written request will then be submitted. Once submitted, your new treatment plan will go into effect the next billing period. 

Account Holds

Latitude Mental Health will notify any member whose account has been placed on hold and after receiving notification the member will have 7 days to bring their account current and in good standing. In the event that you encounter some unusual financial hardship, we may negotiate a payment plan on a case-by-case basis. 

Failure to satisfy payment within 30 days may result in termination of membership. In the event payment is not satisfied within 30 days, a termination meeting will be scheduled.

  • Outstanding fees/unpaid account balances will result in your account being placed on “Hold” status. 

  • While in a “Hold” status, you will not be able to receive clinical or administrative services.

  • Account holds are authorized for up to 90 days.  Any accounts that are not reactivated within this period will be referred for treatment plan termination.


Voluntary Termination

If you wish to terminate your membership with Latitude Mental Health, a formal request must be made. Latitude Mental Health does not authorize immediate terminations. Upon request, a termination appointment will be scheduled within 30 days in order to safely discharge the member from our program. At the time of the termination appointment, the member will sign an agreement stating they voluntarily wish to discontinue treatment and services. If requested, a 15 minute Standard Clinical Consultation by phone can be scheduled for the termination appointment rather than the members standard visit type.

Consultations

As a benefit of your membership, every month you receive a complimentary 15 min consultation as needed for discussions related to non-urgent administrative or clinical matters. If additional consultations are needed, we offer 4 options:

  • Administrative Consultation (15 mins with an administrator) - $75 (standard rate)

  • Clinical Consultation (15 mins with a clinician) - $75

  • Extended Administrative Consultation (30 mins with an administrator) - $100

  • Extended Clinical Consultation (30 mins with a clinician) - $100

*Administrative Consultations for matters related to legal, school or work and. Other services provided  include claim reimbursements, prescription refills, membership services orientation and client account management. 

**Clinical Consultations are intended for treatment plan adjustments, new prescriptions, and treatment verification.