*Please Note: Cleary & Associates, LLC does not accept any forms of insurance*
To Schedule An Appointment
Call (205) 518-0516
Cleary & Associates, LLC
Child, Adolescent and Family Psychiatry
Location: 4898 Valleydale Road, Suite A-1
Birmingham, AL 35242
Questions about Insurance
What billing or insurance information will I receive?
Dr. Cleary does not accept nor file insurance. She is not a Medicaid Provider. You must pay in full at the time of your visit. We will provide you a superbill with the necessary information for you to file your claim.
Links to claim forms are provided below for Blue Cross/Blue Shield of Alabama and United Healthcare.
Blue Cross Blue Shield of Alabama
https://www.bcbsal.org/rapidresponse/pdf/CL-438.pdf
United Healthcare
https://www.myuhc.com/content/myuhc/Member/ClaimForms/Static%20Files/CMS1500ClaimForm010402.pdf
Payment Information
We accept the following forms of payment:
-Cash
-Checks
- Credit Cards: Visa, Mastercard and Discover are accepted
(We do not take American Express)
- Debit Cards
Patient Resources- Release of Information to have records sent to your New Provider
Below is the Release of Information (ROI) form that must be completed prior to having your records sent to your new provider. Please include the provider's name, name of practice, address, phone number and fax number. Click the link to get to the Release of Information. Print the release of information. If the patient is age 16 at the date of signing, he or she must sign the ROI with the notary; if the patient is under age 16, a parent must sign the ROI with the notary. Take it to a notary and sign and date the form with the notary. Once the form is complete and notarized, please mail it to our regular mailing address. Emailing the form is not acceptable. There is no charge to have your record sent to your new provider for current patients (those seen within the last year)
Patient Resources-Release of Information (ROI) to obtain a Personal Copy of your record
Below is the form that must be completed prior to having a personal copy of your records sent to you/or parent of patient. Please include name of who is to receive the record, address and phone number . Click the link to get to the Release of Information (ROI). Print the ROI. Take it to a notary and sign and date the form with the notary. If the patient is age 16 at the date of signing, he or she must sign the ROI with the notary; if the patient is under age 16, a parent/legal guardian must sign the ROI with the notary. Once the form is complete and notarized, please mail it to our regular mailing address. Emailing the form is not acceptable. There is a charge to have a personal copy of the record sent to you. ($1 per page (pages 1-25) then .50 for each additional page. There is an additional $10 mailing fee. ) You will be contacted by phone to collect payment prior to copies being mailed.