What do I need to know about insurance and fees?
I am in network with Blue Cross Blue Shield PPO. If you plan to use your mental health benefits, I will file claims to insurance for you. I am also an out-of-network provider for many insurance companies which means that I do not bill them directly. You will be required to cover the cost of session, however, I will provide a statement that you can submit for out-of-network reimbursement.
I encourage you to call your insurance company and carefully check your mental health benefits as you are ultimately responsible for the full cost of therapy. Here are some questions you should find answers to:
- Do I have Mental Health benefits?
- Is my therapist in-network?
- What is my deductible and has it been met?
- Do I have a copay?
- How many mental health sessions per year does my insurance plan cover?
- How much does my plan cover for an out-of- network mental health provider?
- How do I obtain reimbursement for therapy with an out-of-network provider?
- Is approval required from my primary care physician?
If you are using insurance, only your copay (which varies depending on your plan) is due at the time of your session. If you are using out of network insurance, full payment is due at the time of the session. I accept cash, check and major credit cards.
Feel free to call if you have any questions about fees and insurance.
What are the advantages of private-pay?
Paying for therapy services on your own (private-pay) without relying on insurance or other 3rd party payors allows you to maintain the most control over your privacy by minimizing the exposure of your protected Health Information (PHI).
Did you know that whenever you use insurance benefits to cover psychotherapy, the provider must release certain types of information to the insurance carrier? This is done to a) verify your eligibility for coverage, b) pre-authorize services (If applicable), and c) process claims to obtain payment. As a result, the provider is required to inform the insurance carrier of relevant personal matters such as the nature of the issues you struggle with, your psychiatric diagnosis, and your prognosis. This diagnosis is maintained on your health records, even once therapy has ended, and is accessible by other medical providers.
In the event of private-pay, your therapy remains completely private (with the exception of confidentiality such as in the event of persistent suicidal ideation, etc…). You must provide signed consent to consult with any other provider, institution, agency or individual in your life. No reports of your treatment are shared with your insurance and all records remain with me. The few exceptions to this privileged relationship will be explained in detail during your first appointment.
Keep in mind there are certain types of therapy that may not be covered by your insurance plan, such as couples therapy or group therapy. Medical insurance can also manage the frequency and duration of psychotherapy sessions rather than accommodate your schedule and frequency of therapy. Private-pay allows you to also determine the length of your treatment based on your needs rather the allotted session benefits.
What about confidentiality?
Your sessions and all information you disclose are confidential. Except for the instances below, whi ch are required by law, I will not share information or respond to inquiries of any kind from any source without your written consent.
Legally required exceptions to this confidentiality policy include:
- Threats of serious bodily harm to another person or persons, which must be reported to the police and intended victim(s).
- Suspected child abuse, dependent adult abuse, or elder abuse, which must be i mmediately reported to the appropriate authorities
- Intent to inflict self -harm, which will prompt efforts to engage the client’s cooperation in se curing their safety. In the absence of such cooperation, safety measures will be ta ken without client permission, as provi ded by law.
- In some instances, the courts may subp oena my records or testimony. In most instances, I am required to honor these subpoenas.
- If you choose to cover any portion of your therapy costs wi th insurance, then your insurance carrier will have access to the dates of your appointments and to your diagnosis.
What are your office hours?
What is your cancellation policy?
How should I contact you?
Feel free to contact me to inquire about services.
If you prefer, you are welcome to contact me via the “Contact Me” form on the Website or by email.