insurance and fees
+ What Are Your Fees?
- Consultation (30 minutes) $50.00
- Consultation (60 minutes) $100.00
- Initial Intake Session $250.00
- Individual/Couples Counseling (60 minutes) $150.00
- Individual/Couples Counseling (90 minutes) $175.00
- No-Show Fee $100.00
- Late Cancel Fee (less than 24 hour notice) $100.00
- Group Therapy TBA
+ What If I Want To Use My Insurance?
Those with insurance coverage are expected to pay the co-payment or co-insurance at the time of service. If your insurance coverage is rejected, then you will be responsible for the full fee. You should call your insurance company prior to our first session to verify benefits including my in-network participation, determine co-pay amounts, and get information on deductibles, prior authorization or the need for a doctor’s referral. Clients should be aware when using insurance that we are required to provide a diagnosis which becomes a part of your healthcare record.
If you have questions about health insurance, please call the customer service number located on the back of your insurance card. Here are questions you should ask. Here is a form you can use:
+ Do You Take My Insurance?
I am in-network with the following insurance companies:
- Blue Cross Blue Shield
- Health Advantage
(I strongly encourage you to check with your insurance plan to ensure that your mental health therapist is covered and considered in-network with your insurance plan)
+ What If You Don't Take My Insurance?
For many other insurers, I am considered an out-of-network provider.
Out-Of-Network Benefits Instructions
If your therapy insurance carrier is not listed above, you might have out-of-network benefits that could off-set the cost of services. In order to assist you in determining your own reimbursement from your insurance provider, outlined below are the steps you may take in order to ascertain the actual benefits available to you.
Make sure you keep careful records of your conversation in the event you need to appeal a future decision by the insurance company.
Need help submitting claims for Out of Network (OON) Benefits? Get Better, Inc. provides an app to make OON claim submission easy. For more information, visit their website: https://www.getbetter.co/
Call the number on the back of your insurance card for the Benefits Department and ask the following questions: Here is a form you can use:
- What is the representative’s name and extension number?
- Does my policy cover an Out of Network, Licensed Professional Counselor or Marriage and Family Therapist?
- My therapist is willing to provide a statement (aka, Superbill) of Session Dates Attended, the CPT code, and the diagnosis. Is this acceptable to the insurance company?
- Does my policy cover Individual Psychotherapy (CPT code 90837) or, if applicable, Couples Counseling or Sex Therapy (if so, which CPT code is required). Please note, most insurances do NOT cover Couples or Marriage Counseling, or Sex Therapy.
- What mental health diagnoses are NOT reimbursable?
- How many session are covered per year?
- What is the lifetime maximum for mental health benefits?
- What is my Out of Network deductible?
- What is the allowed amount of the fee?
- What percent of the allowed amount will be reimbursed?
- How do I file a claim?
NOTE:Many insurance companies will reimburse a percentage of the total fee paid. For example, your company may reimburse you 80% of the total fee paid. ($120 of the total fee of $150.) Other companies will substitute the $150 fee for what they deem appropriate, regardless of what you paid. For example, your company may say that they will reimburse you 80% of the “allowed amount of the fee.” You paid $150 for an individual session, but your insurance company only allows $100; therefore you will be reimbursed 80% of the $100 or $80. They may try to withhold this information from you and can legally do so. Ask to speak to a supervisor and convey to them that you cannot plan your medical expense budget without this number.
Regardless of insurance plans and benefits, clients are fully responsible for the payment of all fees not covered by their insurance plan at the time of service including cancellation/no-show fee, return check fee, reverse debit/credit transaction fee, and any additional fees as described by Monique Randle, LCSW.
+ What If I Don't Have Any Insurance?
For those who want to work with me, and do not have insurance or have a high deductible, please contact me and let’s talk.
+ I'm Not Sure I Want To Use My Insurance?
Why would you want to pay out of pocket for mental health services? There are many reasons why not using your insurance benefits and choosing to self-pay is a good idea. Here is an article with 5 great reasons: Paying for Therapy Out of Your Pocket
+ How Do I Pay?
Cash, check, debit cards, and all major credit cards are accepted. A debit or credit card has to be on file at the time of service. All debit and credit card payments are processed through a electronic health record technology system.
If you have any additional questions or concerns, please contact me.