Guide to Paying for CSB Services

Fees

The CSB charges fees to help pay some of the cost of our services (see the CSB Fee Schedule and the CSB Fee Regulation). We ask you for information so that we can set your fees appropriately. We then update this information at least once a year, or whenever your information changes.

The CSB accepts cash, check, money order, and credit cards for payment at the time services are provided. The CSB will file health insurance claims for you with most insurance plans.

Health insurance

The CSB has agreements with the following health insurance plans and can file claims and accept reimbursement, but you are responsible for paying all insurance copays, coinsurance, and deductibles:

• Anthem Blue Cross PPO and POS
• Anthem Healthkeepers Medicaid
• CareFirst Blue Cross PPO and POS
• Commonwealth Coordinated Care plans:
• Anthem Healthkeepers MMP
• Humana Gold Plus Integrated
• Virginia Premier Complete Care
• InTotal Health Medicaid
• Medicare
• Tricare Standard
• Virginia Medicaid

Some health plans, like Kaiser Mid-Atlantic, will only pay for services performed by a provider within their network. The CSB cannot accept those types of health insurance plans as payment for CSB services.

Fee for missed appointments

If you are unable to keep your scheduled appointment, please notify your case manager or therapist at least 24 hours in advance. If you do not provide this advance notification and do not appear for your appointment, the CSB will charge you a $25 fee for the missed appointment.

What to bring to your first visit

The following information will be required at your first visit. By bringing these documents, you will help us process your registration efficiently.

• Proof of identity (such as a driver’s license or other state-issued ID card, school picture ID, passport, picture ID issued by an embassy or consulate, or a birth certificate)
• Proof of residency in Fairfax County, Fairfax City, or the City of Falls Church (such as a lease agreement, letter from current landlord, mortgage agreement, DMV change of address card, driver’s license or other state-issued ID card with current address, utility bill with your name and current address, or a letter from homeless shelter if you are currently homeless)
• Health insurance cards, including Medicaid and Medicare cards
• Name, address and telephone number of your current primary care physician and/or therapist
• Proof of legal guardianship and/or proof of guarantor assignment, if needed.
• Also, if you have income, please bring:
• Most recent Social Security Annual Earning Statement (or 1099 form or award letter)
• Most recent income tax return (preferred)
• Recent pay statements (pay stubs) for the past month for self and spouse if married.

We may ask your permission to call your employer to obtain missing pay information.

If you have no income, you will be asked to certify that the information is true to the best of your knowledge. 

If any of this information changes in the future, please let us know so that we can your financial information in our records.

Financial assistance

You may be eligible for financial assistance if you:

• Live in Fairfax County or in the cities of Fairfax or Falls Church
• Have limited or no health insurance
• Are not eligible for Medicaid
• Demonstrate financial need with proper documentation

Ability to pay

The CSB's basic subsidy of its fees is the Ability to Pay Scale. The cost-sharing percentage is based on income and number of dependents as reflected in your most recent tax return.

An individual with income less than $18,091 or a family of 3 with income less than $30,631 will not be charged for outpatient services.

Payment options

Don't let your payments fall behind! Delinquent accounts may be placed for collection. Instead, speak with CSB staff about payment plans, deferred repayment agreements, and supplemental subsidies.

Should your account be past due or turned over to a collection agency, you will be subject to the full amount outstanding plus any applicable collection agency fees. Collection agency fees can range from 20% to 30% more than your original balance.

Affordable Care Act

As of 2014, you are required by law to have health coverage or obtain an exemption or pay a tax when filing your federal income tax return.

You can obtain the necessary coverage through your job, through a government program such as Medicaid or Medicare, through the health insurance marketplace in Virginia, or directly from an insurance company. You may be able to obtain an exemption from paying the tax penalty, either from the health insurance marketplace or through the tax filing process. Ask to speak with a CSB Financial Assessment and Screening Team specialist about your options.

Annual review of fees

Fees are reviewed and established annually by the CSB Board and submitted to the Fairfax County Board of Supervisors and the Fairfax and Falls Church City Councils. Your account will be reviewed annually so that the most accurate and current information is used to determine your fees.

Where to call if you have questions about service costs and fees

We appreciate the opportunity to serve you and welcome feedback to improve your experience with the CSB. If you have feedback, questions or need additional information, please speak with the administrative staff at the site where you receive services, or you can contact the Billing Office staff at 703-324-7026, 12011 Government Center Parkway, Suite 836, Fairfax, Virginia 22035.

Updated July 6, 2017