In order for us to set realistic treatment goals and priorities, it is important for you to evaluate what resources you have available to pay for your treatment. I provide initial consultations for $175 and ongoing therapy at the rate of $130 per session for individuals and $150 per session when a client would like a partner or family member to join the session.
I am a contracted provider for Blue Cross Blue Shield PPO and Indemnity plans. For other health insurance plans, I am usually covered as an “out-of-network” provider, which means you would pay the fee directly to me, and then be reimbursed after you submit the required paper work. I can give you an invoice at the end of each month, for you to give to your insurance company. Not all insurance plans have out-of-network benefits, so it is important that you speak with your insurance provider before using this payment option. Some helpful questions to ask your insurance would be:
- Do I have out-of-network benefits to see a licensed independent clinical social worker (LICSW)?
- If so, what percentage do you cover?
- What is the deductible, and how much of the deductible have I met?
- What is my co-pay for a session if I see an out-of-network provider?
- How many sessions are covered, and in what time period?
- How do I access the form(s) needed to submit a request for reimbursement?
- Always ask for a confirmation number for the phone call when you speak with your insurance, just in case.
Some clients prefer to pay for sessions directly or “out-of-pocket.” When you pay the fee privately and directly to me, I do not have to provide any of your clinical information to a third party payer, maintaining a higher level of privacy and confidentiality. This also gives us the opportunity to decide the frequency and duration of our work based on your needs and circumstances, rather than on the number of sessions your insurance allows. Deciding how to pay for therapy is a personal decision, and there is no right or wrong answer. If you have questions about fees or insurance, please contact me.
Good Faith Estimate Disclosure
Section 2799B-6 of the Public Health Service Act (also called the “No Surprises Act”) that began on January 1, 2022 was designed to prevent patients from receiving surprise medical bills for care that they are paying for with out-of-network benefits or out-of-pocket. This means health care providers need to be able to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. This is called a “Good Faith Estimate.”
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
You have the right to receive a Good Faith Estimate in writing at least one business day before your medical service or treatment. You can also ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule an appointment or service.
If the service is recurring, you may ask for a summary estimate for the expected course of treatment.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit http://www.cms.gov/nosurprises.
Lauren Schiffer, LICSW, MPH 