FEES & INSURANCE
The accessibility of therapy is important to me which is why I was an in-network provider with commercial plans since graduating with my MSW in 1996. However, after more than a decade of remaining committed to accepting insurance in my solo private practice, I became an out of network provider with all commercial plans as of 1/30/24 and with the State Health Plan as of 4/30/24.
What this means & how I can help: You as the client will directly pay me my fee (please email me for my current rates) at the time of service and have the following options:
Please be aware that it is your responsibility to:
*If you will be seeking reimbursement from your insurance plan, please contact your insurance company and ask the following questions:
For more information on my fees based on specific services provided, please email me at [email protected].
COUPLES/RELATIONSHIP THERAPY is an out of pocket expense, as most insurance plans typically do not cover it. For insurance to reimburse for services, there must be an identified client with a legitimate diagnosis on which the focus of treatment centers and it has to meet medical necessity. In couples or relationship counseling, both individuals are the clients, relationship counseling is considered a Z-code and doesn’t meet medical necessity. Therefore, please be aware that I cannot "creatively bill" insurance for couples work in order to ensure coverage, which is considered insurance fraud.
ACCESSIBILITY: The accessibility of therapy is important to me and I have a limited number of reduced fee spots for psychotherapy clients. If you believe you are in need of a reduced fee, please refer to The Green Bottle diagram to begin to determine where you think you fit. We can then discuss this together to determine an appropriate rate if I have a reduced fee spot available.
What this means & how I can help: You as the client will directly pay me my fee (please email me for my current rates) at the time of service and have the following options:
- You may choose to keep your mental health care services confidential by paying full fee for my services and I will not share your private health information (PHI) with anyone for reasons related to payment or reimbursement.
- You may choose to pay full fee for service and either:
- submit claims yourself, in which case I can provide you with a "super bill" for services rendered -or-
- ask me to electronically submit claims on your behalf as a courtesy in order to expedite the process by which you are reimbursed directly by your health insurance plan for any out of network (OON) benefits* you may have.
Please be aware that it is your responsibility to:
- directly contact your health insurance plan in order to understand your *out-of-network (OON) benefits*
- update me - if I am submitting claims on your behalf - on any and all changes in coverage as soon as you are aware that they will occur as the claims I submit are based on the information you have provided to me about your insurance coverage for each date of service.
*If you will be seeking reimbursement from your insurance plan, please contact your insurance company and ask the following questions:
- Am I able to be reimbursed for seeing an out-of-network mental health provider?
- Do I have an out-of-network deductible that I must meet before being able to access out-of-network benefits? If so, what is my deductible and what portion of that have I already met?
- What is my co-payment and/or co-insurance rate for the following CPT codes: 90791, 90834, 90837?
- Is prior authorization or a referral required before seeking mental health services?
- Is there a limit to the number of sessions I may receive?
- How much can I expect to be reimbursed for my sessions with an out-of-network mental health provider?
- What is the typical wait time to receive my reimbursement check from my insurance plan?
For more information on my fees based on specific services provided, please email me at [email protected].
COUPLES/RELATIONSHIP THERAPY is an out of pocket expense, as most insurance plans typically do not cover it. For insurance to reimburse for services, there must be an identified client with a legitimate diagnosis on which the focus of treatment centers and it has to meet medical necessity. In couples or relationship counseling, both individuals are the clients, relationship counseling is considered a Z-code and doesn’t meet medical necessity. Therefore, please be aware that I cannot "creatively bill" insurance for couples work in order to ensure coverage, which is considered insurance fraud.
ACCESSIBILITY: The accessibility of therapy is important to me and I have a limited number of reduced fee spots for psychotherapy clients. If you believe you are in need of a reduced fee, please refer to The Green Bottle diagram to begin to determine where you think you fit. We can then discuss this together to determine an appropriate rate if I have a reduced fee spot available.
FEES FOR SERVICES OTHER THAN PSYCHOTHERAPY
If there are other professional services you need, I will break down the hourly cost in 15 minute increments for periods of less than one hour. Examples of other services might include report writing, telephone conversations lasting longer than 5 minutes, preparation of records or treatment summaries. Scheduled phone or telehealth sessions will be billed at the hourly rate.
Because of the safety, trust and sensitive nature involved in a client-therapist relationship, I prefer to not be involved in any legal proceedings on your behalf. My doing so can have a harmful effect on the therapeutic relationship. If you do become involved in legal proceedings that require my participation, you will be expected to pay for all of my professional time, including preparation and transportation costs, even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge $350/hour for preparation and attendance at any legal proceeding. If you are seeking services to fulfill a court order or anticipate involvement in legal proceedings that would require your therapist's involvement, please let me know and I will refer you to another provider.
I accept payment in the form of debit card, credit card and health savings account cards. All clients are required to put a debit card or credit card on file with the SimplePractice client portal (which will safely encrypt the card number) in order for me to collect your session fee as well as balance due for sessions missed or cancelled with less than 48 hours notice. If your payment is returned by my bank or yours (e.g., due to insufficient funds), please be aware that you are responsible for a $25 fee for each returned payment. Unless you and I have made a different mutually agreed-upon arrangement, your balance for missed or late-canceled appointments is due within one week of the date of invoice.
NO SURPRISES ACT: Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
Because of the safety, trust and sensitive nature involved in a client-therapist relationship, I prefer to not be involved in any legal proceedings on your behalf. My doing so can have a harmful effect on the therapeutic relationship. If you do become involved in legal proceedings that require my participation, you will be expected to pay for all of my professional time, including preparation and transportation costs, even if I am called to testify by another party. Because of the difficulty of legal involvement, I charge $350/hour for preparation and attendance at any legal proceeding. If you are seeking services to fulfill a court order or anticipate involvement in legal proceedings that would require your therapist's involvement, please let me know and I will refer you to another provider.
I accept payment in the form of debit card, credit card and health savings account cards. All clients are required to put a debit card or credit card on file with the SimplePractice client portal (which will safely encrypt the card number) in order for me to collect your session fee as well as balance due for sessions missed or cancelled with less than 48 hours notice. If your payment is returned by my bank or yours (e.g., due to insufficient funds), please be aware that you are responsible for a $25 fee for each returned payment. Unless you and I have made a different mutually agreed-upon arrangement, your balance for missed or late-canceled appointments is due within one week of the date of invoice.
NO SURPRISES ACT: Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
