Rates & Insurance

Rates:

$165 per 60 minute session – Weekday

Insurance

** PLEASE NOTE: I only accept fee for service clients.  Payment is due at the time of service.  If you want to submit claims to your insurance for possible reimbursement, I am able to give you a ‘superbill’, which is basically an invoice with all of the information that the insurance company requires.  You will then send the superbill into your insurer and if they are going to reimburse part or all of your session cost, payment will be sent directly to you. Please understand, insurance companies must have a diagnosis in order to process your claim.  So if you want to submit claims for reimbursement, you will have a mental health diagnosis within your medical records.  This requirement is true for all medical providers. You need to assess for yourself how you feel about this.

Filing claims/reimbursement

I am considered an out-of-network provider.  You may have out-of-network benefits that will pay all or part of your costs, and your insurer should be able to clarify this for you.  Please contact your provider to verify how your plan compensates you for ‘out of network behavioral health’ services.  I’d recommend asking these questions to your insurance provider to help determine your benefits:

• Does my health insurance plan include out-of-network mental health benefits?
• Do I have a separate out-of-network deductible?  If so, what is it and have I met it yet?
• Does my plan limit how many sessions per calendar year I can have?  If so, what is the limit?
• Do I need written approval from my primary care physician in order for services to be covered?  Or, do I need a prior authorization before beginning services? (Given by the insurer to you).

A Word of Caution Regarding Submitting Claims to Insurance

Should you decide to submit claims to insurance, you will be provided with a billing statement that includes all the information your insurance company should need to process the claims. It is your responsibility to determine if your insurance pays ‘out of network’ benefits.  Still, it is important that you are aware of some of the issues involved. Please understand that the information provided here is not meant to discourage you from submitting mental health claims to insurance, but is intended to keep you fully informed.

Some of the downsides…

Many people, even though they have insurance coverage that would allow them to be reimbursed for mental health services, elect not to submit those claims to their insurance carrier for reimbursement.  Instead, they pay out of pocket for services. The reason is that there can be some ‘downsides’ to submitting claims to insurance.

First, your insurance company will not provide coverage for a mental health claim unless that claim is submitted along with a diagnosis of a mental health disorder, as well as an eligible procedure code.  This means that if you do submit claims to insurance, there will be a mental health diagnosis code in your (or your child’s) medical record.

Note: If you or your child are already receiving medication for anxiety, depression, stress or ADHD, etc., please know that submitting additional claims to insurance won’t make any difference, in that there is already a diagnosis in your record.

I want you to be aware (people do not realize this) that “protected health information” such as service and diagnoses codes becomes a permanent part of your insurance company’s records and is stored permanently in national medical information databases, such as the national Medical Information Bureau’s database, which is the largest repository of medical records in the United States and Canada.  The problem is that this information is no longer fully private, and is in fact utilized by other insurance companies as they evaluate “actuarial data” to determine premium rates and viability of future applications for insurance coverage.

Finally, at the present time insurers cannot discriminate based on a preexisting condition.  Please be aware that should this part of the ACA (Affordable Care Act) be overturned, your medical records could influence life and health insurance coverage and rates.  This would be particularly unfair because most people can fully recover from anxiety, depression, PTSD etc., yet would still be viewed as more of a ‘risk’.  Let’s hope this protection in the ACA never changes!

Please be advised that I have no control over what your insurance company does with your health information once it is in their hands and I assume no responsibility for how that information is managed after it leaves my office.

Payment

I accept cash, local check and all major credit cards as forms of payment. Payment is due at the time of service.  Please note, there is a $25.00 fee for all returned checks.

Cancellation Policy

If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you may be charged for the full rate of the session.

Any Other Questions

Please contact me for any additional questions you may have. I look forward to hearing from you!

 

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