Client Policies/Insurance

Intake Paperwork

COMPLETE PAPERWORK PRIOR TO YOUR FIRST APPOINTMENT
Please use the following links to complete the required new client paperwork prior to your first visit.

These forms are available on-site at the agency as well. Please plan to arrive at least 15 minutes prior to your scheduled appointment time if you prefer to complete these forms at the time of your appointment.

Download Adult Client Intake Paperwork

Download Child/Teen Intake Paperwork

 

Insurance & Financial Assistance

This November we will accept Medicaid and Medicare for counseling services for eligible clients, and by November 17th, 2021, we expect to be an “in network” provider for Aetna, Humana, and Blue Cross Blue Shield insurance companies.  By accepting insurance, Cornerstone has to modify our fee structure.  Effective immediately for new clients, and beginning on January 1st, 2022 for current clients, the fees charged directly to your insurance provider for the following types of 50-minute sessions utilizing insurance are as follows:

  • Individual counseling is $150 per session
  • Couples, family, and EMDR counseling is $175 per session

We never want financial limitations to prevent our grieving clients from getting the help they need.  Therefore, if you are not eligible to utilize your health insurance or choose not to, we are able to offer a $75 “prompt pay discount”. If payment is made at the time of service, the fee structure for a 50-minute non-insurance session will be:

  • Individual counseling is $75 per session
  • Couples, family, and EMDR counseling is $100 per session

In addition, we will continue to provide additional funds through our income based “Financial Assistance Policy” and “Same Household” discount based on application and approval for those who qualify.

Please check our Fee & Financial Assistance Policy below.  Should you have any questions, please do not hesitate to reach out to our Clinical Director, Ryan Edlind, at 216-524-HOPE or Ryan@Cornerstoneofhope.org.

 

Read our Fee & Financial Assistance Policy here.

Download our Financial Assistance Form here.