INFORMATION - Fees, Suggested Reading Material, and Insurance Information
The current fee schedule is as follows (subject to change):
A normal course of therapy will be one initial evaluation appointment followed, if accepted as a patient, by individual 45 minute appointments as scheduled. Frequency of appointments will depend on your need, the recommendation of the therapist, and other considerations as applicable. Generally we will meet more frequently at the beginning of therapy with increasingly longer spans of time as you apply CBT principles as homework between sessions.
I see adults 18 and up. I have closed my practice to adolescents and couples. I also do not see children. If I do not offer the services needed I can generally refer cases out to other therapists/psychiatrists as appropriate. I recommend you can discuss the specifics of your case with me prior to an evaluation if you have questions and/or special needs.
Fees are due at the time services are rendered and can be made with credit cards (MasterCard, Visa, Discover, and American Express), debit cards, cash, or check. Documentation for your insurance out-of-network benefits can be picked up after your session once payment has been made.
Records are available for continuity of care to other health professionals free of charge. Please submit any request for records in writing and allow two weeks (14 days) for processing. Any other copies of records will be assessed a $25.00 fee and will need a written request as well.
Disability and other insurance paperwork may be subject to an administrative charge. Please alert the therapist to any additional paperwork needs as soon as possible. Payment for any records or documentation is required before such records will be released to a third party. In addition, a written Release of Information form should be filled out for each recipient of health information that is not for the patient’s sole use.
Regarding Insurance Benefits
I am an out-of-network provider for all insurance plans. This means that I do not file a claim against your insurance, but you can file on your own behalf. I can help you navigate through this process. It is actually very easy. The field of mental health is more and more going towards this model for good reason. Here are several reasons I do not participate as an in-network provider.
When your insurance pays out towards your care they have access to personal information regarding your treatment. These may include, but are not limited to, your current symptoms, issues you are discussing, my subjective diagnosis of your case, your prognosis, and any other information that they may need to evaluate your case.
Authorizations and Over-diagnosis
It takes a great deal of time for me to communicate with your insurance provider. Authorization is the process by which the company approves your ongoing care from any practitioner. While physical health is a bit more easily determined, mental health benefits are up to the discretion of the case manager who reviews your information at the insurance company.
In order to provide services to those in need many practitioners over diagnose a patient in order to provide, from the best motive, the care the practitioner believes is best.
When the insurance company is eliminated I get to devote more time to your case rather than waiting on the phone for an hour to authorize your visits, your diagnosis is kept confidential for only you and for me, and I do not have to hire an additional staff person which would escalate my rates.
Your insurance company is more interested in keeping you happy than keeping me happy. Therefore the process of getting paid is completely different. Given this situation it is not in my best interest to participate in this way. However, I want you to get benefit from your insurance.
I will provide you a receipt which can be forwarded to your carrier with an additional form for processing. You will then receive a check for the portion of my fee that is paid by your plan. This amount will vary from around 40% up to 70% depending on your specific plan. Any additional information to your carrier will be by your authorization only. Just contact me for any assistance with this process.
Instructions for Submitting an Out-of-Network Claim
Call the customer service number for Mental Health and Substance Abuse Claims (NOT Medical Claims) and get information on where to send the information for processing and what they need to be included with the fee receipt we provided for you. Generally you will have to give them your member number and group number. Clarify what they need so that it does not delay the processing of your claim. Any questions can be cleared up at this step. This is a very common procedure for the insurance company and will be easy once you know where and how to send this in to your carrier.
Note that if you do not route your claim correctly through the Mental Health and Substance Abuse channel then you will have to correct this to get your claim covered.
I have provided everything on the fee receipt that is required of our office. Most insurance companies have already dealt with my office and have it on file. If a company does not have us on file then I can provide any additional information to them to expedite the processing of your claim. Please let me know as soon as possible if you need my assistance.
If clinical information is to be shared with your insurance provider, outside of the fee receipt, I will ask for a release of information from you. Please alert me to fill out a release of information form so that this can be on file should there be future questions.
Many of my patients use this coverage to pay for a portion of their therapy costs and it is my experience that these claims are paid quickly and as appropriately billed given your condition and the procedures performed.
If you have questions please do not hesitate to contact the office.
Suggested Reading Material
Albert Ellis Institute
American Association for Anxiety Disorders
American Psychiatric Association
American Psychological Association
Beck Institute for Cognitive Therapy and Research
Depression and Bipolar Support Alliance
National Alliance for the Mentally Ill
National Clearinghouse for Alcohol and Drug
National Institute of Mental Health
SAMHSA's Center for Substance Abuse Prevention
Substance Abuse and Mental Health Services Administration
Substance Abuse Treatment Facility Locator
The Zen Center