This practice is happy to help those clients who do not have insurance that I'm paneled with OR who decline to use their insurance.
If the latter applies, I'll need to have this decision on file. For those who plan to use their out-of-network benefits, with its higher deductible, you pay the practice before the session, just as other clients do. I will prepare a statement containing all necessary session information, CPT codes, and identifiers so that you can turn this into your insurance company to seek reimbursement. That would come directly to you since you will have already paid the practice.
Insurance Networks Accepted
Insurances accepted at this time include: CIGNA, United Healthcare, Johns Hopkins Employee Health Plan (EHP), Carefirst or BCBS. I have recently applied to be a Medicare provider as well.
I also participate in a few employee assistance programs for presenting problems that are appropriate to the shorter, 45-minute sessions.
Clients are responsible to know their insurance benefits and communicate this detail to me. Very often you can save "outpatient mental health" benefits into a PDF from your insurance portal. Clients also must obtain authorizations.
Your policy statement sent when you inquire about services will list up-to-date, usual and customary fees. Don't let this confuse you, please.
If I accept your insurance plan, however, I accept the insurance company’s rate that’s contracted with my practice, which will be lower than these quoted, private-pay rates.
It's imperative that you fill out the PDF forms I send completely. I've done this work for nearly 19 years, thus if I ask the question, I need you to fill out the blank as legibly as possible. I also need a wet signature. E-signatures aren't accepted.
When & How Do I Submit Copays?
We're all accustomed to stopping at the front desk to pay for medical services. Counseling is no different. This practice kindly asks that you pay your member portion one day ahead or early in the morning of your appointment. This truly helps keep record of your payment. No one likes to be chased for payment, and your provider would much rather provide care to other clients. We can't thank you enough for following this helpful policy!!!
This practice accepts Zelle and PayPal. With PayPal, avoid selecting professional services because fees are removed; choose another option, please. This practice will indeed receive a 1099 for tax purposes, but this avoids an email or call due to an incomplete payment. Again...thank you for making billing easier.
Payment Options
This practice accepts contactless payment methods that went into play during the global pandemic. These include PayPal, Mastercard, VISA, Discover or Zelle.
Clients are asked to furnish credit card information with their paperwork, as a backup payment method to keep an account current. This is rarely used, but could be for missed sessions or third-party contact necessary to clinically coordinate your case, with physicians and insurance care managers, for instance.
Payment is due the day before or the same morning of your scheduled appointment.
The vast majority of clients are immensely respectful of a therapist's limited time, and of their scheduled appointments. Sadly in nearly 20 years of practice, these policies have been instituted out of need, and they are communicated in greater detail, as a result, on your Informed Consent and the forms you sign in entering into a therapy agreement.
Late Cancel or Missed Appointments
CANCELLATION POLICY is 48 hours in advance of your appointment OR FRIDAY in advance of a Monday appointment. You will not receive a reminder. So take care writing this down to remind yourself of this obligation.
Should you miss or cancel a session within this 48-hour window, it cannot be billed to your insurance company; thus, you'll be responsible for full-fee charges (not your copay, but full fee).
True emergencies mean a death in immediate family, documented ER or hospital visit, or serious illness. Sports practice, games, work, sitter snafus are not exempt. Immediate family = spouse or domestic partner, a child, or a parent.
Add therapist to your contacts because she'll contact you if you are not signed into the telehealth platform. If you have a couples or family session, and one has a schedule conflict, the other person can do the session and save you paying a late-cancel fee. Again, thank you for heeding the policies spelled out in your Informed Consent.
What Insurance Does NOT Cover
Your insurance/EAP will not cover missed sessions. You'll have to pay ($164 for one hour or $95 for an EAP session, more if billed to your credit card). See above for detail.
Out-of-session time necessary for proper case coordination with physicians, school counselors, other treating providers, attorneys and anyone else is billed at my hourly rate, pro-rated.
Should a client require inpatient treatment, partial hospitalization or substance abuse treatment, there will most always be outside consult necessary for discharge or treatment planning. Effort is made to keep time as minimal as possible for financial reasons.
Outside of quarterly or yearly statements, administrative fees may apply for paperwork/invoicing because payment is due at time of service. Therefore, once again, please know your benefits as this knowledge empowers you as the consumer.
Required Forms
Currently, this practice does not have fillable PDF forms. You'll be sent PDF forms to fill out and return. This likely involves your using a printer and a wet signature (in pen) will be required on policies/insurance forms unless you have a digitally stamped signature. Few people have this, at this time, but some do.
You'll be given a secure HIPAA-compliant fax number to return your paperwork to. You can also use a password-protected PDF, which is easy to configure using a Mac computer and some others. Send the passcode in a separate communication to your therapist, please. These are the most secure means of sending back your required paperwork.
