1. ARE YOU CONSIDERED AN IN-NETWORK OR OUT-OF-NETWORK PROVIDER?

I am considered an out-of-network provider for all insurance plans. So long as you have out-of-network coverage (which most PPO plans do), insurance will reimburse for a portion of the fee.

Although I am out-of-network, I still "take insurance" in that I offer to file claims directly on your behalf.  If the insurance company is willing to send the reimbursement check to me, you will only be charged your coinsurance (and any additional fees that insurance may not cover).

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2. HOW DOES PAYMENT WORK?

Standard practice is that the full fee is due at the time of the session.  Payments are accepted in cash, Zelle, PayPal or Venmo.  I offer to submit claims to insurance on clients' behalf on a monthly basis.  Most other practices just provide a monthly receipt, and you are responsible for filing all of the paperwork.

After reimbursement from insurance, clients' portion for each session tend to be around $30-80, though each plan is different so you should speak to your insurer to clarify.  If it is financially difficult to pay the full fee upfront and wait for reimbursement, I do offer flexibility in the payment schedule depending on the need, so please feel free to ask.

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3. INSURANCE JARGON CAN BE CONFUSING!  THIS WILL HELP YOU UNDERSTAND SOME OF THE TERMS:

Here are definitions of common terms you are likely to find in your policy:

• Deductible: The amount you pay for health care services before your insurance begins to pay.  For example, if your deductible is $1,500, you would pay 100 percent of your health care charges until the amount you paid reaches $1,500. After you reach your deductible, insurance kicks in and reimburses at whatever rate is set within your plan.

• Co-Insurance: Your share of the costs of a health care service. It’s usually figured as a percentage of the total charge for the service.  Say you’ve already or met your $1,500 deductible and your coinsurance is 20 percent. For a $200 health care bill, you would pay $40 and your insurance company would pay $160.

• Co-Payment: A fixed amount you pay for a health care service, usually when you receive the service (e.g. $50). Typically, your insurance plan will have either a co-insurance or co-payment, but not both.

• “Usual and Customary Rate”: The going rate for a medical service in a geographic area based on what providers in the area usually charge for the same or similar medical service.  My fees are considered “usual and customary” for the SF Bay area.

• In-Network: A provider who is contracted with a specific insurance to be a preferred provider in their network.

• Out-of-Network: A provider who is NOT contracted with insurance and is not a preferred provider within the network.

• Out of Pocket Maximum: The most you pay during a policy period (usually one year) before your health insurance or plan pays 100% for covered essential health care services. This limit must include deductibles, coinsurance and/or copayments.  If your out-of-pocket maximum is $3,000, insurance will pay 100% of covered services after you’ve paid $3,000 for the benefit year.  

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4. DO YOU OFFER REDUCED FEES OR A SLIDING SCALE?

YES. I feel it is important that counseling be available to as many people as possible, no matter their financial circumstances. I am open to sliding or reducing fees depending upon one's financial situation. Please contact me if you need a reduced fee.

 

IF YOU HAVE OTHER QUESTIONS, PLEASE FEEL FREE TO CONTACT ME.