Payment for Services: FAQs

Do you take my insurance?

At this time, I am a provider for several insurance plans, including EAPs. Due to the ever-changing nature of insurance company mergers, restructuring, etc., a complete listing of panels of which I am a part cannot be made. To verify whether I am an in-network provider for your particular plan, you will need to contact your insurance company’s mental health services department. An Insurance Benefits Worksheet is included in the New Client Intake Packet, and is provided to guide you in getting that and other necessary information from your insurer.

What if you aren’t on my insurance?

Clients who are not using insurance for which I am a network provider are expected to pay the full fee-for-service at the time of service.
Some insurance plans will cover some services for out-of-network providers, and require that a client submit proof of service and of payment to the provider. If you have an insurance plan with out-of-network benefits, you can file a claim with your insurance company to receive whatever reimbursement your benefits allow. At your request, I will provide you with a statement that contains all of the information that your insurance company needs to process the claim, or I may be able to file the claim electronically for you.

What if I don’t have insurance?
Clients who do not have insurance are expected to pay the full fee-for-service at the time of service.
I do not offer a sliding scale – however, I do reserve a very limited number of spots in my client caseload for the negotiation of lowered fees; if a mutually satisfactory agreement can be reached, that client would be expected to pay the full negotiated fee at the time of service.

What if I have insurance, but it doesn’t include any mental health benefits?
Clients who have major medical insurance without mental health benefits are expected to pay the full fee-for-service at the time of service.
I do not offer a sliding scale – however, I do reserve a very limited number of spots in my client caseload for the negotiation of lowered fees; if a mutually satisfactory agreement can be reached, that client would be expected to pay the full negotiated fee at the time of service.

What if I have insurance with mental health benefits, but I don’t want to use my insurance?
Clients who have major medical insurance with mental health benefits (and for which I am a provider) have the option whether to use their benefits. If they choose not to use insurance, they are expected to pay the full fee-for-service at the time of service.

What are the pros & cons of using my insurance benefits to pay for mental health care?
Many people prefer to use their insurance benefits because it is usually less expensive for the client than it would be to pay the full fee-for-service, themselves.

However, your insurance plan will likely cover the cost of services you receive only if the provision of services is for reasons considered to be “medically necessary” by your specific insurance benefit plan. If you have a diagnosis of something like a mood or anxiety disorder, your insurance plan will probably cover the services you receive. However, if you are seeking counseling/psychotherapy for “life problems” such as relationships, problem-solving, personal growth, etc., your insurance plan may classify these issues as “not medically necessary,” and may deny use of benefits to you for these services.

If the appropriate diagnostic code assigned to you is not “eligible” for your insurance benefits to be paid, the insurance company will deny the claim, and you will be responsible for payment in full.
Also, your insurance plan will likely cover the cost of services you receive only if the services are of a type “allowed” by the plan. Some types of services (e.g. distance counseling, extended-length sessions, multiple sessions in a single day, reports or letters written on a client’s behalf by the therapist, etc.) are generally not covered by insurance plans.

NOTE: when filing your insurance claims, all providers are required to report a psychiatric diagnosis for you. This diagnosis becomes part of your medical record in a medical information database shared by insurance companies. Please be aware that any ethical mental health clinician will not “assign” a diagnosis to you for a condition that you do not have, just so your insurance company might pay for services that it deems “medically necessary”!

What forms of payment are accepted?
cash (exact change only, please)
check
debit cards
credit cards: Visa, Mastercard, DiscoverCard, AMEX
HSA credit or debit cards

YES.
NOPE.