Billing & Insurance
Therapy sessions are billed by time. Your first appointment, termed Initial Intake, is a 60-minute session. In this session you share the reason why you’re seeking therapy. We then explore your history such as your upbringing, education, and relationships. You can think of this session as a time to share your story. Most clients find this session to be more helpful than they thought as they start to see the events that lead to their current struggle. All following sessions are typically 45-minutes; however, some insurance companies allow for 60-minute sessions. The amount of sessions you need depends on your goals. I will not confirm an Initial Intake session with you until I verify your insurance and determine what, if any, cost you will be responsible for. You need to make an informed decision about your financial responsibility. Payment is collected at time of service.
Insurance Coverage
The amount you may have to pay toward your session is based on your insurance benefits. Most people do not understand how insurance works. Please note that I am unable to accept Medicare. I have provided you with the following information to assist you:
In-Network Provider
In network refers to providers or health care facilities that are part of a health plan’s network of providers with which it has negotiated a rate. Insured individuals usually pay less when using an in-network provider, because those network providers provide services at lower cost to the insurance companies with which they have contracts. I am in-network with several insurance companies (see list below).
Out-Of-Network Provider
If I am not in-network with your insurance company, but I do accept your insurance, you may choose to have me bill your insurance as an Out-Of-Network Provider. You will not get the same negotiated rate as if I was in-network and will likely pay more toward your own sessions.
Allowable Amount
The amount insurance will pay for a session. May also be called “eligible expense”, “negotiated rate”, or “payment allowance.” The amount of your session, or the allowable amount, is determined by your insurance company, not me. I charge whatever amount the insurance company has determined. I cannot charge above or below that rate. I cannot alter the amount in anyway. You are in contract with your insurance company just as I am. We both have agreed to the terms of that contract. It is illegal to alter an insurance fee such as waiving or lowering a fee.
Copay
An amount that you will need to pay for each session. Typical co-pay amounts range from $10-$40 per session. You may or may not have a copay.
Co-Insurance
A percentage of the amount that you pay for the session. Insurance companies “share” with you the cost for your session. It is calculated by a percentage, usually 90%-10% or 80%-20% of the allowable amount meaning insurance pays 90% or 80% of the session rate and you pay 10% or 20%. If you have a deductible to meet you don’t start paying co-insurance until after you’ve met your deductible. You may or may not have co-insurance.
Deductible
A specified amount of money you must pay the provider directly before your insurance will begin paying for a session. For example, your insurance may have determined the allowable amount for each session is $66. Your insurance benefits include a $500 deductible. You would be required to pay the $66 at the time of service for each session until you have paid $500. This is termed that you have met your deductible and your insurance would start paying. If you have a coinsurance or co-pay you would start paying that.
Private Pay
The amount I charge for a session. This is a professional, customary rate that I charge. You would be required to pay this rate if you are not using any insurance. My private pay rate is $150 for the Initial Intake session and $120 for 50-minute sessions.
Confidential, Professional, Ethical
When you choose me, you get a well-educated therapist that understands your emotions and unique personal situation; Someone that can guide you on your journey to healing and growth. I will be there with you to help overcome obstacles and assist you in moving forward towards living the life you want.
In-Network Insurance Companies
Contact Me
Have any questions? Contact me via text: 920-355-3300
| Phone & Text: | 920-355-3300 |
| Fax: | 920-482-5789 |
| Email: | triciahelps@gmail.com |