Insurance, Forms, and Payment


Clients may pay for services themselves and/or use their medical insurance.
I have “in-network” contracts with:

  • all Blue Cross Blue Shield networks
  • some PreferredOne networks
  • some UCare networks
  • only the MNSure and Medicaid networks of HealthPartners,
  • Medicare
  • MN Health Care Programs (Medical Assistance/Medicaid).

Virtually all insurance plans will cover my services if the plan includes out-of-network benefits or does not require you to use a specific network of providers.


New clients can print and fill out these forms before coming in for your first session, if you wish. If you’d rather wait until we meet in person, I will give you the forms then. The “Guidelines For Services” gives you information about my policies and working with me–you don’t need to fill anything out on it.

Forms are in PDF format and require Adobe Reader or similar PDF document reader.

Guidelines for Services (PDF)

Intake Form (PDF)

Cancellation Policy

Late cancellations are disappointing to everyone – you, me, and any clients on a waiting list, hoping for a session sooner rather than later. Please understand that a missed appointment or cancellation with less than 24 hours notice will be charged the full rate for the scheduled appointment.

This notice period consists of business days, not weekends or holidays, as “hours” of notice. For example, cancellations for Monday appointments must be phoned in the previous Friday by Monday’s appointment time.

Cancellations are accepted by phone/voicemail.


Payments by check or cash are preferred.

I accept major credit cards and HSA credit cards. You have 2 options:

  • I welcome payment by GooglePay (GPay) before or at the appointment. There is no service fee if you pay using GooglePay.  Please pay me using this email address:
  • I also accept Paypal payments. Please add $5.00 to the transaction to help cover the fee I am charged by Paypal.

To pay by credit card, please click the G-Pay button or the Paypal button in the sidebar, fill in the amount to pay (adding $5 if using Paypal), and make your payment.

To pay by check, make your check payable to Mindy Benowitz, Ph.D., and mail it to my office address:

Mindy Benowitz, Ph.D.
2908 Humboldt Avenue S.
Minneapolis, MN 55408