Fees
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My usual fee for a standard 50-minute session and the related prep,
analysis and paperwork time is $150.00. Clients on insurance
plans
that I accept (see below) pay the copay and/or rate set by their
insurance plan and coverage. I do also offer some "sliding scale"
sessions at
reduced rates, with priority going to those with a true need. Fees or
copays are due at the end of each session.
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Insurance Plans
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I'm currently an approved provider for these insurance plans:
Blue Cross of California
Blue Shield of California
Managed Health Network (MHN)
PacifiCare Behavioral Health (PBH)
ValueOptions
Health Net
United Behavioral Health (UBH)
This list changes from time to time, so feel free to check with me if
you'd like to use an insurance plan that isn't on that list.
Please also note that many insurance plans subcontract
their mental health coverage to a separate subsidiary or another
company—for example, mental health coverage for most Health Net
members is provided by MHN. Consequently, whether you are
in-plan or out-of-plan may depend on such an assignment.
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Authorizations |
Most MHN, PBH, UBH and ValueOptions members have coverage that
requires
preauthorization and limits the number of sessions paid for by
insurance. Most Blue Cross plans do not require preauthorization, but
many do have limits. I can usually
arrange for an initial authorization within a few days of receiving
your insurance information. |
Out of Plan
Option, Voluntary Self-Pay
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Many other insurance plans have an out-of-plan provision that will pay
a large portion of the session fees. If you choose this course, I will
provide the statements of charges that you'll need to seek
reimbursement from your insurance carrier.
For a variety of reasons, some
clients who do have insurance choose to pay for their own sessions
without involving the insurance company. In such instances, no
paperwork is sent to the insurer regarding the treatment
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Annual Deductibles
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If you have an insurance plan with an annual deductible
amount,
you will
have to pay the full negotiated rate for your insurance until you have
reached your deductible with me or your insurance company tells me your
deductible has been met. If this results in an overpayment,
you
will get a check back from me or your insurance plan once they
have received and approved bills that exceed the deductible
value
specified in your coverage.
Once you insurance carrier specifies that your deductible has been met,
the only fee due from you for any further sessions in the year is the
copay specified in your insurance plan. I regret that an initial
overpayment is often necessary--but that's the way the deductibles
system has been structured. |
Scheduling and
Missed Sessions
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Most clients prefer a regular weekly session with a reserved time
spot, but some would rather take available spots on a week to week
basis. In either case, once a session time is agreed on, I set it aside
for
the exclusive use of the client. If you're a client with a
scheduled session, you must tell me 48 hours in advance that you need
to reschedule or cancel to avoid being charged for the full amount of
the session (which for insured clients generally means both the normal
copay amount and the fee that would have been paid by the insurance
company). There are reasonable exceptions for illness and
serious
emergencies as specified in the agreements provided to new clients. |
Billing and
Statements
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Fees or copays for each session are expected at the time of the
session. The basic paperwork of billing insurance companies is included
in the fees for your session, as are basic receipts and statements if
required. More extensive paperwork, such as special
statements, EAP questionnaires
and disability reports that involve significant amounts of preparation
time may incur an additional charge.
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