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$160 per 45-50 minute session $80.00 per 30 minute session of EMDR with a 60 minute minimum. $175.00 Per Couples

Cigna Aetna UHC Optum Humana Avmed

We are currently out-of-network for most insurance plans for a few reasons. Insurance companies require a mental health diagnosis be added to your permanent medical record before approving services. Many clients have come to me who have problems that they desperately need help with and do not qualify for a medical diagnosis. Couples Therapy is one of them. Many insurance companies will not pay out for this therapy due to not having a diagnosis available that couples meet criteria for. Insurance companies often restrict the length of treatment and the type of services that can be offered. Many insurance companies will only allow for a 45 minute session and often times refuse to pay out for a session that goes over this amount. Theyrequire reviews of clinical documentation and discussions to support the cliniciansclinical judgment. In-network insurance providers agree to allow auditors to review your therapy records. Optum is one of these providers that continuously have CIOX reviewing charts. This breaks confidentialityand prefer not to have auditors looking at your records whenever they feel like it to prove medical necessity so that they again, do not have to pay out and leave you stuck with a surprise bill. We want your confidentiality to be our primary focus and not have your records breached. Many insurance plans have in-network mental health deductibles that are so high it won’t save you any money to stay in network, so why not see someone of your own choosing who is out-of-network? The fees insurance companies allow for psychotherapy are often less than half of the actual cost for therapy. Our fees are comparable to the Clearwater, Dunedin, Palm Harbor, and Tarpon Springs areas. I encourage you to check the independent nonprofit FAIR Healthfor your ZIP code and the procedure code 90837 to see the actual cost of therapy. We will provide you with a superbill that you can submit to your insurance company for reimbursement at their Out-of-Network rates, that will pay for at least 50% of the cost. You will be responsible for the full payment at the time services are rendered. Many people ask, “How do I know if my insurance will pay for out-of-network benefits?” Call them and ask! The following questions are very useful: 1.Do I have coverage for outpatient mental health psychotherapy and related mental health benefits? For individual psychotherapy, the code is CPT code 90837. 2.What is my deductible? Has it been met? Does it need to be met? 3.Do they require pre-authorization? If so, try to obtain thenumber prior to meeting with us. 4.Do you need a referral from your pcp or other medical provider? 5.What is the amount of coverage for an out-of-network provider? (They often give a percentage for this) 6.What is the time limit to submit claims and where should they be mailed?

Notification of Federal Protections against Surprise Billing: Good Faith Estimate for uninsured clients 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. Your health care provider shall provide you a Good Faith Estimate in writing prior to your medical service or item. You can also ask your health care provider and any other provider you choose (to work with), for a Good Faith Estimate during scheduling. If you receive a bill that is substantially higher than estimated on (more than $400 than) your Good Faith Estimate, you can dispute the bill. It is a good idea to save a copy of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit https://www.cms.gov/nosurprises For more information about your rights under federal law, visit: https://www.cms.gov/nosurprises/consumer-protections/Payment-disagreements