Insurance and Financials
Prior to calling for an appointment, please contact the mental health carrier for your insurance company and find out if I am an in-network provider. While on the phone, you may want to ask if you have a deductible that needs to first be met, and/or what your copay or coinsurance amount will be per session.
In-Network: If I am in your network, you may have a deductible, but will more likely only have a copay, or coinsurance payment (a percentage of the contracted allowable amount).
Out-of-Network: If I am not in your insurance network, you may have out-of-network benefits, which means you may have to first pay a deductible, and after the deductible is met (paid down), you will then be responsible for paying a small percentage of the contracted allowable amount.
Contracted Allowable Amount: The amount that the insurance 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 this amount. Likewise, the contract also does not allow me to undercharge or reduce the amount I have agreed to collect, including the deductible.
Prior to your first visit, you will receive an email with a link to input your insurance information. This goes directly to my medical billing specialist. You will then receive an email regarding benefits and coverage information. Billing is completed at the end of each month, and you will receive an Explanation of Benefits (EOB) once the insurance processes payment. This EOB will inform you as to the amount you are responsible for, and what the insurance company paid me. While we always check your benefits prior to services beginning, there is not a guarantee that what was quoted is what is actually covered once the billing is processed by your insurance company.
The first visit is always the longest visit – usually 1.5 hours. If the client is a child, this first visit is always with the parents only, in order to get background and family history, and review practice policies and procedures, financial information, and sign releases to collaborate with other practitioners, service providers, or organizations/schools. The out-of-pocket cost for this session is $195.
Each visit thereafter is a normal 50-minute session in which the out-of-pocket cost is $150 per session. Payment is due at the end of each session. If the client is a child, the second session will be with the child/adolescent. The first two sessions are considered an assessment phase designed to inform treatment planning.
I am no longer conducting evaluations through insurance, but only through private pay. Billing regulations and changing codes have become too cumbersome once a cost/benefit analysis was done. If I accept your insurance, I can't accept private pay for evaluations, as this is against contract regulations. I can only accept private pay if I am not a provider with your insurance.