Insurance and In-Network Benefits
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Aetna, Beacon Health Options (New York State Empire Plan, GHI/Emblem Health Network), Cigna Behavioral Health, Horizon Blue Cross Blue Shield, Medicare, Optum Health (United Behavioral Health), and Oxford. To verify your benefits and eligibility, call the customer service, or member benefits, phone number on the back of your insurance card. You might be able to find information about your benefits and eligibility on your insurance company’s website. Make sure you inquire about your mental health, or “behavioral health,” benefits. Behavioral health benefits that pay for mental health services, are different than your medical benefits.
It’s important to understand the details of your mental health/behavioral health insurance benefits. You might need preauthorization or a referral. Your benefits might only include a limited number of therapy visits and we would need to submit requests for more visits. You need to know if you have a deductible to pay before your insurance will start contributing to the cost of the sessions. You might have to pay the contracted rate for psychotherapy visits until you have met your deductible, and then the insurance will begin to pay a portion of the session. When you reach your deductible limit, you will still need to pay a co-pay or co-insurance at the time of each session. Co-pay amounts for behavioral health services might be different than co-pay amounts for medical visits. Co-pays, benefits, and plans might change from year to year so make sure you have up-to-date information.
Sometimes it’s difficult to know exactly what portion of the session you will have to pay until we receive an Explanation of Benefits (EOB) from your insurance company. We will work together to communicate with your insurance company.
Out-of-Network Benefits
I am also an out-of-network provider for all other insurance plans as long as you have mental health out-of-network benefits. If you want to use your out-of-network benefits, you would pay the full fee for the psychotherapy and I will give you a bill to submit to your insurance company for reimbursement.
Professional Fees
(All fees are due at the time of visit. I accept cash, checks, and credit cards.)
$190… Initial Evaluation (First visit usually an hour for Individual, Couple, and Family Therapy)
$180… Weekly Session (45 minutes for Individual, Couple, and Family Therapy)
$120… Cancellations and Missed Visits*
$25…. Returned Checks
*Cancellations and Missed Visits
It is expected that we will meet weekly unless we agree it’s clinically appropriate to meet at a different frequency. All cancellations and missed visits will be billed at $120, Even If You Give Me Prior Notice Unless Rescheduled That Week, or if due to the following circumstances – hospitalization, death of a loved one, illness requiring you to stay home, or vacation with advance notice. I will try to reschedule a cancellation or missed visit in the same week if we can coordinate schedules, but if it is not possible you will be responsible for the cancellation/missed visit charge of $120. Insurance will not pay for these charges. You are held responsible to pay for cancellations and missed visits.
I charge at my Weekly Session fee for other professional services you may need, though I will break down the hourly cost if I work for periods of less than one hour. Other services include report writing, telephone conversations lasting longer than 15 minutes, consulting with other professionals with your permission, preparation of records or treatment summaries, and the time spent performing any other service you may request of me. Fees are subject to change periodically to reflect changes in the cost of living and of doing business.