Let’s talk payment.
Please note that at this time, I am only able to offer self-pay and have limited sliding scale rates. In the coming months I hope to panel with insurance companies in North Carolina to help make mental health care services more accessible.
Insurance.
Will provide superbills upon request.
A superbill is a document made for insurance companies that details the services a therapist or health care provider performed for a client. Essentially, it’s a receipt for your visit to the doctor’s office, but unlike traditional receipts, superbills contain vital information, like diagnosis and procedure codes, needed for insurance payers to reimburse you for the services after you’ve paid. They're different from regular medical bills in that insurers use them to pay patients rather than providers.
Currently, I am not paneled with insurance companies.
Self-pay rates.
Initial intake session (55 minutes) $200
Individual sessions (55 minutes) $150
Group Therapy (1.5 hours, 3-6 clients) $60
Sliding scale.
I am a firm believer that mental health services should be accessible. If you feel you cannot pay the full price, I am happy to discuss sliding scale options with you. Contact me directly to establish a price based on the specifics of your financial situation.
While I don’t currently accept insurance, I am hoping to be paneled within the year. Regardless, I think it is important for clients to understand their benefits offered. Below is a glossary of insurance terms for your convenience.
To inquire about coverage for therapy, you can request details regarding your out-of-pocket responsibilities for "behavioral health telehealth or in person services in an outpatient office setting." Keep in mind that most deductibles restart January 1. If you do in fact need to meet your deductible, my initial session fee when using insurance is $150 and $130 for subsequent therapy sessions.
Glossary of Insurance Terms
Annual Deductible
The amount you are required to pay annually before reimbursement by your health care benefits plan begins.
The deductible requirement does not apply to preventive services.
Annual Limit
An insurance plan may limit the dollar amount it will pay during one year for a certain treatment or service, or for all benefits provided in a year.
Benefits
The health care items or services covered by an insurance plan. Your insurance plan may sometimes be referred to as a "benefit package."
Claim Form
A form you or your doctor fill out and submit to your health care benefits plan for payment.
Claim
An itemized bill for services provided to a member.
Coinsurance
The percentage of the costs of a covered health care service or prescription drug you pay after you've paid your deductible. You pay 100 percent of the full allowed amount until you meet your deductible.
Copay (Also Known As Copayment)
The set dollar amount you pay for a covered health care service at the time you receive care or when you pick up a prescription drug.
Covered Person
The eligible person enrolled in the health care benefits plan and any enrolled eligible family members.
Covered Service
A service that is covered according to the terms in your health care benefits plan.
Deductible
The amount you pay for most covered services before your health plan starts to pay. When you go to a provider that is in the plan's network, before you meet the deductible you may pay a discounted amount that has been negotiated with the provider. The deductible resets at the beginning of the calendar year or when you enroll in a new plan.
Dependent
An eligible person, other than the member (generally a spouse or child), who has health care benefits under the member's policy.
Effective Date Of Coverage
The date your coverage begins. Please note: The effective date can also represent the date a change in your coverage takes effect. If you have questions, call the number on the back of your ID card.
Explanation Of Benefits (Eob)
An EOB is created after a claim payment has been processed by your health care plan. It explains the actions taken on a claim such as the amount that will be paid, the benefit available, discounts, reasons for denying payment and the claims appeal process. EOBs are available both as a paper copy and online.
Group
A group of people covered under the same health care plan and identified by their relation to the same employer or organization.
Hipaa
A federal law that outlines the rules and requirements employer-sponsored group insurance plans, insurance companies and managed care organizations must follow to provide health care insurance coverage for individuals and groups.
Individual & Family Health Plan Out-Of-Pocket Maximums
The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copays and coinsurance, your health plan pays 100 percent of the costs of covered benefits. For plans that cover more than 1 person, individual out-of-pocket maximums count toward the family out-of-pocket maximum. Once the family out-of-pocket maximum is reached, the plan pays 100 percent of the cost of covered benefits for everyone on your plan. The out-of-pocket maximum doesn't include your monthly premium payments or anything you spend for services your plan doesn't cover.
In-Network
Services provided by a physician or other health care provider with a contractual agreement with the insurance company and paid at a higher benefit level.
Out-Of-Network
Services you receive are considered out of network when you use a doctor or other provider that does not have a contract with your health plan. When you go to an out-of-network provider, benefits may not be covered, or may be covered at a lower level. You may be responsible for all or part of the bill when you use out-of-network providers.
Out-Of-Pocket Maximum
The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copays and coinsurance, your health plan pays 100 percent of the costs of covered benefits. The out-of-pocket maximum doesn't include your monthly premium payments or anything you spend for services your plan doesn't cover.
Outpatient Services
Treatment that is provided to a patient who is able to return home after care without an overnight stay in a hospital or other inpatient facility.
Preauthorization
The process by which members or their primary care physicians (PCP) notify the health plan in advance of treatment plans, such as a hospital admission or a complex diagnostic test. Also called pre-notification.
Premium
The ongoing amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly or yearly. The premium may not be the only amount you pay for insurance coverage. Typically, you will also have a co-payment or deductible amount in addition to your premium.
Preventive Care Services
Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.
Provider
A licensed health care facility, program, agency, doctor or health professional that delivers health care services.
Referral
As applicable to HMO or point of service (POS) coverage, a written authorization from a member's primary care physician (PCP) to receive care from a different contracted doctor, specialist or facility.
Utilization Management
The way we review the type and amount of care you're getting. This involves looking at the setting for your care and its medical necessity. Examples may use prior authorization, case management, accompanying reviews or proper discharge planning.