Insurance and Payment

My current fee is $205 for a 55-60 minute session. Although I'm not in network with most insurance panels, many plans have out-of-network benefits to offset a portion of that cost. Before reaching out, please contact your provider to determine your plan’s out of network coverage.

Below is a breakdown of how to do a benefit check.

Understanding plans and coverage can be difficult and stressful. For this reason, I offer a billing service to manage claims.

In-Network Coverage:

I'm currently in-network (preferred provider) with PacificSource and PacificSource OHP.

Out-of-Network Benefits:

Benefit check:

Verify Coverage:

Call the number on your insurance card for the Benefits Department.

• Confirm whether your policy includes out-of-network benefits.

Annual Deductible:

• If out-of-network benefits are available, you’ll need to find out the annual deductible for outpatient mental health.

• An annual deductible is the amount you must pay for covered services before insurance starts contributing. Once you've paid this amount, your insurance will begin covering a portion of your medical expenses according to your plan's terms.

• Ask for the Out Of Network Deductible, the amount you must pay before your plan will cover a portion of my fee.

• Some out of network deductibles are reasonable, others can be in the 4-5K range.

Know the allowed amount:

• Learn the Allowed Amount of Fee for a therapist with my credentials, LCSW.

• This is the maximum sum your insurance company is willing to pay per hour for my services. This is generally in the area of $100-$150.

Co-Insurance:

This is where the headache really begins.

• Determine the percentage of the Allowed Amount that your insurance will reimburse for an LCSW (my credentials) The “allowed amount” can be anywhere from $105-$165. It’s impossible to know without doing a full benefit check.

• For example, if you have a 50% co-insurance, your insurance covers 50% of the Allowed Amount. If the allowed amount is $130, insurance will pay $65, and your co-insurance (what you need to pay) would be $140. ($205-$65 = $140)

Benefits of Private Pay:

Opting for private pay comes with several advantages:

Confidentiality & Privacy:

• Private pay ensures that your therapy sessions remain confidential, with records not shared unless you decide otherwise.

Freedom of Choice:

• Enjoy the freedom to choose a therapist based on your preferences, unconstrained by insurance limitations.

Flexibility:

• More flexibility in session frequency and duration without being bound by insurance constraints.

Focus on Your Needs, Not Insurance Mandates:

• Private pay allows us to maintain a client-centered approach, focusing on your specific concerns and goals without interference of your insurance.

Reduced Administrative Hassle:

• Private pay reduces administrative costs

  I offer a 15% discount, reducing the session fee to $175 if you opt for cash pay, or file your own insurance claims.

  If you want to process your own claims, I can provide a “Super Bill”

Accepted Payment Methods:

• Cash, Check, MasterCard, Visa, Discover, and American Express.

• Health insurance debit cards (HSA).

At our initial session, I’ll ask for your credit or HSA card information, then securely store it in my electronic health record.

While I don’t offer a sliding scale, a percentage of my practice is dedicated to pro-bono clients.

Therapy requires a commitment of time and finances.

I require 24-hour notice for cancellations, respecting the shared commitment to our time together.