Financial Policy and Explanation of Insurance Companies / Mental Health Benefits
Out-of-Pocket Private Pay:
$195 for the first visit -1.5 hours. $150 for each 50-minute session thereafter. Payment is due at the time of visit. A credit card can be kept on file and billed after each session if this is preferable. There is a 3.5% surcharge when a card is used.
Insurance and Terminology
*** Beginning January 1, 2025 I will only be accepting Blue Cross Blue Shield PPO insurance. I can provide you with a "superbill" that you can submit to your insurance company, and you may be reimbursed. See insurance benefits for details. ***
Prior to calling me for an appointment, please contact the mental health carrier division of your insurance company and find out if I am an "in-network provider". Ask if you have a deductible that needs to first be met, and/or what your copay or coinsurance amount will be per session.
Contracted Allowable Amount: This is the amount per session that your insurance company has contracted with me that can be collected per session. I am contracted to accept that specified amount per session and am not allowed to charge over - or under - this set amount. These amounts vary from insurance company to insurance company, and vary depending on the type of session (initial interview, therapy with client, family therapy without client, family therapy with client). Each type of session pays a different amount that may range as low as $70 or as high as $175.
Deductibles: The total amount you have to pay providers out-of-pocket before your insurance kicks in. I am not allowed to reduce the amount of deductible that you pay me. It is against the contract that I signed with your insurance carrier.
Co-Pays: A pre-set amount you pay per visit (e.g., $25 per session) versus
Co-Insurance: A percentage of the contracted allowable amount that you pay (e.g., 80/20 split means insurance pays 80%, you pay 20% of the contracted allowable amount).
In-Network: I have a signed contract with your insurance carrier's mental health company to provide outpatient mental health services to your child or dependent.
Out-of-Network: I am not in your insurance network. Some insurance companies have out-of-network benefits which means you pay more to go outside of your insurance network. Commonly one must first pay down a deductible which may be paid down by contracted, allowable amount, versus the full amount you actually pay me. After the deductible is met (paid down), your insurance kicks in and you will be responsible for paying a percentage of the contracted allowable amount and that percentage varies from company to company (e.g., 70/30 or 50/50, etc.).
Explanation of Benefits: I file claims with your insurance company. Once the claim is processed you will receive an Explanation of Benefits (EOB). This EOB will inform you as to the amount you are responsible for (if anything), and also what the insurance company paid me. While I always check your benefits prior to services beginning, there is no guarantee that what was quoted during this initial check of your benefits is what is actually covered when the claim is processed. You are responsible for any amount not covered by your insurance.
Superbills: If I am not in your network, and you want the amount that you are paying me to go toward paying down your deductible, I can provide you with a "superbill". This is essentially a receipt that has everything the insurance company needs to process your payments toward paying down your deductible. Your insurance may only reimburse the "contracted allowable amounts" - versus the amounts that you have paid me out of pocket.
Evaluations and Insurance Billing:
I do not conduct evaluations through insurance, as the only evaluations that I do are not covered by insurance (educational, IQ).