Fees and Insurance

Fees are set during our initial phone consultation before the first session. I reserve a limited number of sliding scale slots for clients who are unable to pay my full fee of $150 per 50 minute psychotherapy session. (Sliding scale rates range from $90-150 per 50 minute session.) For supervision for unlicensed clinicians, I charge $80 per hour. For late cancellations (less than 24-hour notice) or missed appointments, I charge our predetermined fee for a 50-minute session. For those using their insurance to cover psychotherapy sessions, I charge my contracted rate for an individual 53+ minute session with your insurance plan for late cancellations or missed appointments, which typically amounts to $100.  

At this time, I am accepting Highmark Blue Shield and a limited number of other Blue Cross Blue Shield plans (but not Independence Blue Cross). Please note that many insurance plans require their policy holders to meet a deductible before reimbursing providers. It is best to check with your insurance plan before our first session in order to verify that I am in network with your plan and what the out-of-pocket cost will be. I will gladly provide you with my National Provider Identification number (NPI) and office address beforehand if needed. If your insurance plan does not cover the cost of our sessions, either due to a deductible or any other reason, you are responsible for the unpaid amount of my contracted rate with your plan. I can also provide super bills for you to submit to your insurance company if your plan offers some coverage for out-of-network providers, and if you’d like to request reimbursement for my services from them.

For the following services I charge my full hourly fee:

–        report writing

–        providing copies of medical records or treatment summaries

–        attending meetings with other professionals on your behalf

–        involvement in legal proceedings, either at your request or by that of a third party

I will notify you of any applicable charges before billing for those additional services. Please note that insurance will not cover these additional services.

Payments for sessions or other billable services can be made using debit, credit, or HSA cards. I gather payment information through my practice software’s secure platform and charge the card on file after our session is complete—usually the same day, but occasionally by the end of that week. In compliance with the 2020 No Surprises Act, a Good Faith Estimate of the yearly cost of my services is available upon request. Please feel free to ask me any questions about fees or payment at any point throughout our work together.

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treatment by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs, or have to pay the entire bill if you see a provider or visit a health care facility that is not in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—for instance, when you have an emergency, or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balance billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You are never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.Your health plan generally must:
• Cover emergency services without requiring you to get approval for services in advance (prior authorization).
• Cover emergency services by out-of-network providers.
• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors at (717) 783-1389 or via ticket on their website:
https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/SocialWorkersMarriageanFamilyTherapistsandProfessionalCounselors/Pages/default.aspx