Do you need to pay your Arrowleaf Invoice?
It’s easy! Here’s how:
Pay by Cash, Money Order, or Check
Cash or check payments are preferred. Please do not send cash payments in the mail. If paying by cash, please visit us in person to submit your payment.
If paying by Money Order or Check, please mail your payment to:
PO Box 1328
Vienna, Illinois 62995
If you have any questions about your invoice or payment options, please call 618-658-3079.
No one will be denied access to services due to an inability to pay. There is a discounted/sliding fee schedule available based on family size and income. To inquire, please call 618-658-3079 or email firstname.lastname@example.org.
Pay with Venmo by searching @myarrowleaf under “Charities” or by scanning the QR code to the left.
Pay Online with Credit Card or PayPal
If you would like to submit an online payment via Credit Card or PayPal, please complete and submit the form below. After submitting the form, you will be taken to PayPal to complete the payment process. (NOTE: You do not need a PayPal account to pay your invoice by submitting the form below.)
Arrowleaf Online Payment Form
No Surprises Act and Good Faith Estimates
The “No Surprises Act” helps ensure that uninsured consumers or consumers with commercial health insurance (health plans provided by an employer or purchased on the Health Insurance Marketplace) do not receive surprise bills for services provided to you at our agency.
If you are uninsured, underinsured, or don’t plan to submit your claim to your health plan, we must provide you with a “good faith estimate” of expected charges. The good faith estimate is NOT a bill.
Arrowleaf must give you a good faith estimate when you schedule an appointment at least three days in advance, or at any time during your treatment if you ask for one.
The estimate will include an itemized list and expected charges for services related to your care. The estimate will be provided in writing or mailed to you if you schedule over the phone.
All clients will be assessed a sliding scale fee during intake for a reduced amount based on household size and income. Additional fee reductions can be applied upon request.
If you get a bill for $400 or more above the good faith estimate, please contact us at 618.652.2047 for a review and dispute of charges.
For more information about the No Surprises Act and Goof Faith Estimates visit www.cms.gov/nosurprises or call 1.800.985.3059.
*Arrowleaf will not deny services due to inability to pay*