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Service Rates
Service Rates
- Initial Intake Appointment, 60 minutes: $250
- Individual Therapy Session, 50 minutes: $200
- Assessments and Evaluations (ADHD, ASD, Comprehensive Clinical, & Immigration): $300 - $2,000 (depending on type of service)
A Good Faith Estimate is made available to all clients at Intake.
A Good Faith Estimate is made available to all clients at Intake.
Questions to Ask Your Insurance Carrier Prior to Iniating Services
Questions to Ask Your Insurance Carrier Prior to Iniating Services
Do you have out of network benefits (OON)? Depending on the insurance plan you choose you may not have out-of-network (OON) benefits. OON is the amount you must pay for out-of-network treatment before your insurance will begin to pay you back for any portion of the costs.
What is your out-of-network deductible (OON)? Knowing your deductible will allow you to know how much money you will have to pay out of pocket before your insurance begins to cover sessions fully or require you to pay a copay. Finding out how much you’ve already spent will let you know how much more you need to spend in order to meet your OON deductible. For example, if your OON deductible is $1,000 and you’ve already spent $850, you will only need to spend $150 more before your OON benefits kick in.
What is Coinsurance? Coinsurance is the share of the cost of a covered health care service that you pay after you’ve reached your deductible. It’s usually a percentage of the approved medical expense. Once you’ve met your deductible, you might pay 20% of the cost of the health service or procedure, for instance. Your insurance company would pay the balance.
Do they cover counseling services? There are times depending on the policy that your insurance will have a different system and/or deductible for Mental Health Out-Patient services. Ask if they cover code 90837 or 90834 (for individual counseling only).
How do you submit for reimbursement? Some insurance companies allow the practice to submit the necessary paperwork which makes the process easier. Joyful Journey Counseling & Consulting, PLLC. only submits claims for in-network covered services. I am happy to provide a Superbill for all OON services I provide.
What is a Superbill? A superbill is a document your therapist will provide to you that will include dates of service, a diagnosis code, a CPT code, and your therapist’s NPI and EIN numbers. It is really important to ask this when speaking with your insurance representative as each insurance company has different procedures when submitting a Superbill.
Submitting Superbills to your health insurance carrier can be made simple by using Mentaya (see below)!
Private Self-Pay
Private Self-Pay
Keep your mental health information completely confidential by choosing to private self-pay for your sessions with me! When you pay directly for your therapy services there is no requirement for me to assign a mental health diagnosis that will forever be on your record and reported to your health insurance company.
Keep your mental health information completely confidential by choosing to private self-pay for your sessions with me! When you pay directly for your therapy services there is no requirement for me to assign a mental health diagnosis that will forever be on your record and reported to your health insurance company.
- Choose self-pay to eliminate sharing sensitive information with insurance companies!
- Choose self-pay to keep you in charge of your mental health care! Insurance companies often dictate how many sessions you are authorized to have, how long each session must be, not to mention, what your diagnosis MUST be (rather than what we both agree on- if any at all)!
- Choose self-pay to ensure your Protected Health Information (PHI) is not shared with any entity for reasons related to your payment for service.
Out of Network Coverage
Out of Network Coverage
I provide out of network (OON) coverage for clients insured by some insurance companies.
I provide out of network (OON) coverage for clients insured by some insurance companies.
Be sure to check you benefits to verify what your behavioral health benefits and coverage are before your first appointment.
Be sure to check you benefits to verify what your behavioral health benefits and coverage are before your first appointment.
Medicare Coverage
Medicare Coverage
Unfortunately, I am not in network to bill Medicare plans. Medicare has very strict rules that do not allow providers to accept a patient's private health insurance independently from their Medicare coverage. Medicare laws also require anyone who carries this health coverage, but who does not wish to use the coverage for a coverable service (e.g., individual outpatient therapy), must enter into a signed agreement with the provider that neither of them will submit a claim for reimbursement. Therefore, you will be responsible for the full out-of-pocket fee without the possibility of reimbursement from your insurance provider(s).
Unfortunately, I am not in network to bill Medicare plans. Medicare has very strict rules that do not allow providers to accept a patient's private health insurance independently from their Medicare coverage. Medicare laws also require anyone who carries this health coverage, but who does not wish to use the coverage for a coverable service (e.g., individual outpatient therapy), must enter into a signed agreement with the provider that neither of them will submit a claim for reimbursement. Therefore, you will be responsible for the full out-of-pocket fee without the possibility of reimbursement from your insurance provider(s).
I've partnered with Mentaya, a service that streamlines getting reimbursed for your therapy sessions through out-of-network benefits.
I've partnered with Mentaya, a service that streamlines getting reimbursed for your therapy sessions through out-of-network benefits.
Mentaya is perfect if you:
Mentaya is perfect if you:
• Have out of network benefits
• Have out of network benefits
• Feel overwhelmed by superbills and insurance
• Feel overwhelmed by superbills and insurance
• Have submitted superbills but failed to get any reimbursement
• Have submitted superbills but failed to get any reimbursement
• Simply want to skip the hassle of paperwork!
• Simply want to skip the hassle of paperwork!
Here's how it works:
Here's how it works:
2. I will enter your sessions into the platform.
2. I will enter your sessions into the platform.
3. Mentaya submits the claim and handles any insurance follow-up.
3. Mentaya submits the claim and handles any insurance follow-up.
4. You get reimbursed by insurance!
4. You get reimbursed by insurance!
Service Fee: Mentaya charges a 5% fee per claim, which includes handling any paperwork required, dealing with denials, and calling insurance companies.
Service Fee: Mentaya charges a 5% fee per claim, which includes handling any paperwork required, dealing with denials, and calling insurance companies.
It's risk-free: They guarantee claims are successfully submitted, or a full refund of their fees.
It's risk-free: They guarantee claims are successfully submitted, or a full refund of their fees.
Your Return: Clients get up to 80% back on their out-of-pocket therapy costs.
Your Return: Clients get up to 80% back on their out-of-pocket therapy costs.
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