Pricing
Service | NCSF Package | A La Carte |
Health (school/camp) forms* | Included | $50 per form packet |
Patient letters of medical necessity/clearance/ advocacy | Included | $50 per form |
Prior authorizations | Included | $50 per call |
Insurance claim and prior authorization appeals | Included | $25 per call |
Prescription refills | Included | $20 per medication per refill |
After hours calls to answering service | Included | $30 per call |
Medical Records | Included | $50 per file |
Billing summaries ** | Included | $5 per page |
Account resolution with company HR and insurance | Included | $25 per 30 minutes |
Immunization Record*** | Included | $10 per request |
*Many children need 2 or more per year
**Billing summaries are often required for FSA/Tax/Legal and other personal purposes.
***Immunization records are available on the portal, included with all health form packets, and can be printed at your well check free of charge. This fee applies for official Maryland form request outside of these parameters.
If you are electing to opt out of the NCSF for primary care and/or mental health services this year, please click the button below. You must complete this waiver for each child for whom you are waiving the bundled package. We must receive your opt out waiver no later than February 28, 2023 at 11:59pm. Due to the complexity of billing for both bundled and a la carte service option, those who choose to opt out of this fee are not eligible to opt into the bundled services until the following NCSF year. NCSF charges for families who have not opted out will begin March 1, 2023, and will be charged under the oldest child for the family.
Therapy & Psychiatry Services
The needs of families who are accessing our mental health department are significantly more than those only utilizing primary care services and therefore the following ADDITIONAL pricing and opportunity to pre-purchase bundled services applies.
Pricing
Service | Package | A la carte |
Health forms | Included | $50 per form packet |
Patient letters of medical necessity/clearance/ advocacy | Included | $150 per letter |
Prior authorizations | Included | $50 per episode |
Prior authorizations with a peer-to-peer communication | Included | $250 per episode |
Peer-to-peer collaboration (with another provider, therapist, school counselor, caretaker) | Included | $125 per episode (Therapist) $250 per episode (Psychiatrist) |
Prescription refills without an office visit | Included | $40.00 per medication per refill |
If you are electing to opt out of the NCSF for primary care and/or mental health services this year, please click the button below. You must complete this waiver for each child for whom you are waiving the bundled package. We must receive your opt out waiver no later than February 28, 2023 at 11:59pm. Due to the complexity of billing for both bundled and a la carte service option, those who choose to opt out of this fee are not eligible to opt into the bundled services until the following NCSF year. NCSF charges for families who have not opted out will begin March 1, 2023, and will be charged under the oldest child for the family.
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Phone: 301-279-6750 | Fax: (301)-208-8953
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