*Individual, Couples and Family Sessions range from the average competitive rate in Orange County.
Fees: Cash patients:
Individual Therapy: $150.00
Couples & Family Therapy: $200.00
Insurance in Network: Optum (United Health), HMC, Beacon Health. You
are responsible for knowing your own Insurance Health Plan, verifying your own insurance benefits, co-payments and deductibles if any that go towards Mental health. Please call the back of your insurance card to verify your Mental Health benefits and if you need an Authorization Code.
Accepts: Cash, Check, major credit cards, health spending cards, and out of network benefits.
If you have a PPO plan you may be reimbursed for part of the fee. Even if I'm not in network, we can still work together if you have out of network benefits. See below for questions to ask when calling your insurance for out of network clinicians.
What you need to know regarding insurance coverage and reimbursement:
You must check with your insurance carrier to see if you can choose your own provider and what your reimbursement for services will be. You are responsible for Co payment or full payment at the time of your appointment depending on insurance benefits. If I'm out of network, I will provide you with a Superbill, which you can then submit to your insurance carrier for direct reimbursement.
If I am not a provider of your Health Insurance, you may be reimbursed for part of the fee if you have a PPO that provides for “out of network” coverage but will not bill your insurance directly. As a licensed Marriage and Family Therapist, I will provide you with a receipt with the necessary information to submit to your insurance company for reimbursement. If you meet the criterion of your insurance company, you may be reimbursed for part of the fee. It is your decision whether to submit your claim(s) for mental health coverage.
Please understand that disclosure of confidential information may be required by your insurance company to process your claims. Submitting the receipt that I provide you for reimbursement can entail some risk to confidentiality, privacy or future eligibility to obtain health or life insurance. Therefore it is important for each individual, couple or family to make an informed decision regarding future reimbursement. Some clients decide to pay out of pocket, and others decide to pursue the matter to get more information.
Here are some questions you may want to ask your Insurance provider for verifying out of network benefits:
I always recommend taking good notes with the accurate names and dates.
1. What is your name and extension number?
2. Am I eligible to submit a claim for reimbursement myself rather than the provider submitting the claim?
3. Do I need pre-authorization in order to be reimbursed?
4. What is the rate of the reimbursement?
5. What is the rate of reimbursement for a “non-preferred” or “out of network” provider?
6. Is there a ” usual and customary fee” that is reimbursed? What is that specific fee?
7. How much can I expect to be reimbursed per visit with an “out of network” provider?
8. Is my reimbursed rate only for specific procedure codes or CPT?
9. What procedure codes in my plan are not reimbursed?
10. Does reimbursement require a DSM V diagnostic code?
11. What specific DSM V codes are not reimbursable?
In researching this topic, I find that licensed Marriage and Family Therapists often have strong beliefs on whether clients should submit claims or pay out of pocket. My belief is that each individual, couple and family may have different needs, access to resources and/or financial concerns that should be taken into consideration before making an informed decision.