Insurance Policy

Your Responsibility:

Please note that it is a client’s responsibility to understand the limitations of their mental health insurance benefits. Not all services are covered and clients may have a deductible to reach, or out-of-pocket expenses per their insurance plan. Not all diagnoses are covered by every insurance plan. If a client’s insurance provider fails to pay for services rendered, the balance of unpaid session fees becomes the client’s responsibility. We encourage you to check your policy yourself prior to receiving coverage for services, to find out all of the information you need to know about your potential costs.

If your copay/deductible is unknown, from the very first visit going forward we will be charging a standard $40 per copay per session. If – once insurance has paid – your insurance asks for a lower copay than $40 then we will happily credit your account the difference in copays. If it is higher, we will notify you before charging the difference and work out a payment plan if it is a significant difference. It is essential that you be as informed as possible – through your insurance company – about your expected rates, as one company (such as BlueCross BlueShield) can have rates ranging from $7.91 to $79.10.

A Note about Deductibles and Out-Of-Pocket Expenses:

Each year on a specific date, deductibles reset. It is essential that you know when that is, as it is not always January 1st. Many insurance companies switch in June for example, not just January. It is important that you realize that if you are paying a low amount right now because you have met your deductible, that your rate will go higher once the reset happens. It is good to keep this in mind so that you are prepared to pay the higher rate when this happens.

It is also important to know that Deductibles are not the same thing as out-of-pocket expenses. You may have met your deductible but not your out-of-pocket limit yet.

Some important Terms to Know:

Deductible – A health insurance deductible is a set amount of money that an insured person must pay out of pocket every year for eligible healthcare services before the insurance plan begins to pay any benefits.

Out of Pocket – Expenses for medical care that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered. Please note that just because your deductible has been met, does not mean that your out-of pocket limit has been met.

Health Savings Plans and Flexible Spending Accounts – We do accept cards from both of these types of accounts but do request a credit or debit card also be put on file for when/if these cards run out. Please note that some rare accounts/plans do not let us charge the card you’ve been given. If that is the case, we will notify you and charge the credit card on file. We can then provide you with receipts and any other documentation your account requests for you to be reimbursed.

Secondary Insurance – We are unable to directly bill your secondary insurance. You will be responsible for paying any copays or deductible amounts up front and then your secondary insurance can reimburse you. We will be able to provide you with the required documentation (called a CMS-1500) as well as a receipt for any copays paid, for you to seek reimbursement from your secondary insurance once your primary insurance has responded to your claims. We cannot provide the form until your insurance has paid or denied the claim for that date.