
Helpful information about the process of working towards acheiving your goals:
~UNDERSTANDING PRIVATE PAY AND OUT OF NETWORK BENEFITS~
~UNDERSTANDING PRIVATE PAY AND OUT OF NETWORK BENEFITS~
SESSION RATES:
Mental Health Evaluation | $600 for the first 120 minutes anything above that is $25 per 15 minutes
Individual Sessions | 55-60 minutes | $200
Couples and Family Sessions | 55-60 minutes | $250
Life Coaching | Starts at $100/hour
Peer support services are based on individual need
Please reach out to see if we can create a plan so that you are better able to work towards your goals. I have created a sliding fee scale to help you to get the services you want/need that may help without causing financial hardship to you and/or your family.
PAYMENT OPTIONS:
Payment is due at the beginning of the session. All payments (other than cash) are done through a HIPPA compliant app for licensed therapists called IVYPAY.
Forms of payment accepted (checks are not accepted):
Cash
Health Savings Account (HSA)/Flexible Spending Account (FSA)
All Major Credit Cards
INSURANCE INFORMATION
I am not in network with any insurance companies so your options are PRIVATE PAY or OUT OF NETWORK (OON) BENEFITS:
IF YOU PLAN TO PRIVATE PAY:
Your treatment information will be kept completely confidential.
You have greater flexibility and say in your treatment.
You are responsible for your agreed upon payment at the beginning of each session.
There will be no insurance reimbursement (in or out of network) requested for services by you or myself.
Private pay means that your insurance company:
Cannot dictate your treatment content, modality, length, or purpose.
They are not entitled to review your treatment records.
You WILL NOT have a psychiatric diagnosis from the Diagnostic and Statistical Manual of Mental Illnesses (DSM) 5 and International Classification of Diseases (ICD) 10 in your permanent medical record.
IF YOU PLAN TO USE OON BENEFITS
Call your insurance company and plan to provide the following information (a form is provided as a part of your intake process):
Do I have mental health insurance benefits?
Is approval/referral required from my primary care physician?
What is my benefit plan year?
What is my deductible?
Does my deductible apply to mental health services?
Has my deductible been met?
How many sessions per year does my behavioral health insurance cover?
What is their reimbursement rate?
What is their process for submitting bills and reimbursement?
If you decide to use OON benefits:
You MUST tell me IMMEDIATELY prior to your first session and have completed the above information about your coverage (there is a form that is a part of your intake process)
The session rate if you plan to claim out-of-net network reimbursement from your insurance company is $200/hour.
You will pay me directly at the time of your appointment
You will be provided an itemized bill upon request that you can submit to your insurance company for reimbursement.
You are responsible for all payments and billing.
You WILL have a psychiatric diagnosis from the Diagnostic and Statistical Manual of Mental Illnesses (DSM) 5 and International Classification of Diseases (ICD) 10 in your permanent medical record.
PLEASE UNDERSTAND THE FOLLOWING:
If you do not tell me that you are planning to use OON benefits and you attempt to collect reimbursement from your insurance company or if you chose to change to using OON benefits with my consent and agreement, your treatment will be terminated immediately.
RIGHTS TO A GOOD FAITH ESTIMATE - NO SUPRISES ACT (Notification Required by Law)
The “No Surprises Act” (the Act), allows for patient financial protections that impact health plans, physicians, and facilities. The “No Surprises Act” is a new requirement to provide a good faith estimate (GFE). Beginning January 1, 2022, health care providers will be required to give new and established patients who are uninsured, or self-pay, or patients who are shopping for care, a good faith estimate of costs for services that they provide.
You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.
Under the law, health care providers need to give clients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Your health care provider shall provide you a Good Faith Estimate in writing prior to your medical service or item. You can also ask your health care provider and any other provider you choose (to work with), for a Good Faith Estimate during scheduling.
If you receive a bill that is substantially higher than estimated on (more than $400 than) your Good Faith Estimate, you can dispute the bill.
It is a good idea to save a copy of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises