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Blackthorn Trusts Andrews RoadBarmingMaidstoneME16 9ANreferrals@blackthorn.org.uk APPLICATION FORM FOR SELF THERAPEUTIC SERVICES Guidelines ABOUT BLACKTHORN The Blackthorn Trust is a long established
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Self-pay therapeutic services refer to health services that individuals pay for out of pocket without using insurance. This might include therapy, counseling, or other treatment options.
Individuals who receive therapeutic services and choose not to use insurance are generally required to file the self-pay form for therapeutic services. This includes patients who prefer to maintain privacy regarding their treatment.
To fill out the self-pay form for therapeutic services, individuals should provide personal information, details about the service received, the provider’s information, and the payment details. It is important to follow the specific guidelines provided with the form.
The purpose of self-pay therapeutic services is to document the services provided to individuals who opt to pay for their treatment directly, ensuring transparency and proper record-keeping for financial and tax purposes.
The information that must be reported includes the patient's name and contact information, the type of therapy or service provided, the date of service, the amount paid, and the provider's details.
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