CHARGES

The actual amount your insurance company pays for the session, and the amount you pay is decided by the insurance company. If you have insurance that covers therapy / counseling - you can bring your partner or spouse to sessions and it is covered.

If you have a set co-pay when you see your doctor, that is likely your co-pay for therapy. If you pay a percentage of the allowable, we will likely know what that amount is IF you call your insurance company and find out what your specific benefits are so we can collect the appropriate co-pay or % you pay for the service AT EACH SESSION.

If I am a provider for your insurance company I am required to bill them and cannot make a cash price agreement.

If you do not make a cash price agreement PRIOR to your first appointment I will not consider flexing from the listed prices.

If you do not show or cancel your first appointment with less than 24 hours notice, I will not reschedule and will not see you in the future.

Co-pays, cost-share and deductibles are due at every appointment.

Fees - which don't matter if you are covered by insurance because the Insurance companies decide how much they cover - how much is required to be written off and how much your % or copay is.

***ONLY THE INSURANCE COMPANY CAN GIVE YOU YOUR DEDUCTIBLE, COPAY, or COST SHARE INFORMATION.

CHECK YOUR BENEFITS & MY PROVIDER STATUS - (Please)

If you don't follow the requirements of your policy and your insurance company does not pay - for any reason - you will be responsible for the entire bill and will be billed until collected.



We will check your benefits if they list them online. We do not call to check benefits.

As far as fees, insurance makes a big difference. Here is the general information. It is detailed because I get so many questions and this usually answers them. The initial session is $205. You will never pay that price. The insurance is charged that and will pay what the insurance company allows / you will pay your copay or % of what your insurance allows. Subsequent sessions are $155. You will never pay that price. The insurance is charged that and will pay what they allow / you will pay your copay or % of what your insurance allows.

If you do not provide the correct insurance or your insurance is not active, you will be charged the full rate because we spent time billing an inactive policy.

If you DO NOT HAVE INSURANCE: Cash rates are $150 for the first session and $125 for subsequent sessions, paid just prior to each session.

The amount I charge is almost irrelevant if a person is covered by insurance. The amount the client pays is based upon what amount the insurance company allows. If the client has a 'cost-share' insurance plan where they are responsible for a percentage of the charges, the percentage they pay is their percentage on the amount allowed by the insurance company, not the amount I charge.

If the client's insurance has a set copay, then that is the amount the client is charged.

If a client has a deductible, they are expected to pay for their sessions at the time of the appointment until their deductible is met.

A client's insurance will cover me if I am on the insurance company's preferred provider list or if the the insurance company provides 'out-of-network benefits' as part of their insurance plan or if their insurance company doesn't require providers to be on a list.

I am on most plans but you MUST check your benefits.

The benefit number is usually listed on each insurance card as benefits, customer service or on the health insurance card following MH/SA (mental health/substance abuse).

Clients should look on their insurance company website or call their insurance company and ask if I am a covered provider if they have a plan requiring providers to be contracted with the insurance company.

If I am not a preferred provider they should ask if their insurance provides 'out of network benefits'.

If their plan covers 'out of network benefits' ask if they will cover a Licensed Marriage and Family Therapist.

Clients should call or make sure they have a referral or authorization if needed as we do not do that.

If you don't check your benefits and don't know what your coverage is, we will guestimate what your portion will be from our experience with your insurance company.

If you check your benefits, we will use your information.

Insurances cover counseling with the individual and / or a family member.

You do not need to ask family, marriage or couple's therapy. The terminology used by clients and insurance companies is different and they will often say no and it will get confusing. Don't worry about it. We know how to bill and what is legal and covered.

*** People ask and re-ask and call their insurance and ask about "marriage" or "couples" therapy. Your insurance will say you aren't covered. Using the term "marriage" is an event or situation that isn't an insurance billable medical health term for the people at your insurance company answering the phone. You have medical insurance and your stress, anxiety, sleep disruption, depression, worry, fear etc... caused by marital or couple difficulties ARE COVERED. Your symptoms qualify you to have your therapy billed to insurance as we are doing therapy to reduce your symptoms by solving the issues causing the symptoms and by helping you to learn to decrease or re-route the symptoms. You can have anyone I agree to - your partner, spouse etc... attend your sessions. Please - just ask the insurance what your copay and deductible for counseling - that is all - do not elaborate about the causing situation - if anything list your symptoms or you will get told "no" by the insurance company and then you will call me and text me and ask me and I want to avoid this. I have been doing this and successfully billing insurance and not billing under fraudulent terms for decades. I am a billing expert in the mental health field.

If you are covered for therapy or mental health benefits you can bring anyone you want with you.

If your insurance says you need a medical diagnosis, don't worry. Stress to life changes or stages is a dignosis. A person is having anxiety and/or depression or other symptoms whether or not the cause is from a relationship, the insurance company will cover the counseling when we are addressing the anxiety and depression or other symptoms that will improve while also addressing how these or other symptoms are caused by or how they impact a client's relationships. Medically covered symptoms can include and are not limited to: anxiety, depression, exhaustion, lack of motivation or focus, explosiveness, obsessions, compulsions, racing thoughts, mood swings, fearfulness, worry, nervousness, panic and substance abuse.

If a person is covered by two insurance plans, they MUST use their primary insurance before the secondary insurance can be billed for the amount remaining after the primary insurance company pays. If we receive inaccurate insurance information from a client and cannot correctly bill the current insurance company and thus the charges are denied, we will be billing the client directly and payment will be need to be paid immediately.

If two people are coming in together and they have different benefits, they will want to check and compare benefits to see whose coverage is best for therapy. Only one person's insurance can be billed for a session. You can schedule two sessions next to each other and then we can bill each person's insurance for one session so that we have more time in a double session.

If I am a provider for an insurance company and we have that insurance information from the client, I have to bill the insurance per my contract with the insurance company and have to go by what they allow charged.

I cannot write off any portion of what the insurance company says the client must pay.

The insurance company will NEVER pay for a NO SHOW or LATE CANCELLATION, telephone appointment or emails or phone calls or letters. These will have to be paid by the client at the next appointment or upon receipt of the bill - whichever occurs first.

Reminders:

Reminders will be automatically sent by the scheduling program to your email or phone via automated message or text per your choice in the scheduling program registration. Reminders go out the morning two days prior to the appointment. Occasionally, system issues with servers interfere with reminders going out but you still are expected to show. Reminders are a courtesy. You can always login the scheduling program and check your scheduled appointments to confirm it yourself. Not receiving a reminder does not waive your commitment to the appointment. Appointments scheduled after the scheduling program window of when reminders go out for your appointment means you will not receive a reminder for that appointment.

This is a small business and I cannot absorb late cancellations or no-show appointments.

EMPLOYEE ASSISTANCE PROGRAMS: 

Many employers have EAP / Employee Assistance Program benefits that provide a number of sessions with a contracted therapist before a client uses their health insurance so the sessions are free to the client and thus without a copay or deductible. These benefits are often available to all employees whether or not they are covered by the health insurance through the employer and whether or not the employee is full or part time.

These EAP benefits are often available to all family members and sometimes to all people living in the employee's home whether or not they are family members. I contract with several EAP companies so it is important to clarify what company your EAP utilizes so that we bill the correct company.

A REFERRAL OR AUTHORIZATION IS ALWAYS NECESSARY FOR AN EAP BENEFIT. YOU CAN GET THIS AUTHORIZATION THROUGH YOUR HUMAN RESOURCES DEPARTMENT OR THROUGH A PHONE NUMBER ON YOUR BENEFIT'S CARD. This number is sometimes on the benefit card following MH/SA (mental health/substance abuse).
I am a preferred EAP provider for Claremont EAP, Mutual of Omaha EAP and others.