General

With the exception of a clients who pay cash or check each visit, there are no monetary transactions at the time of a session.  Patients are generally not billed for coinsurance or deductible until after a claim is processed.  At that point prompt payment from a credit/debit card on file is required.

Insured

This practice is in network with Blue Cross/Blue Shield, BlueLincs, HealthChoice, Medica and OptumHealth (formerly United), Medicare, Medicaid as a Medicare supplement and Medicaid (Soonercare) for children/teens under 21 years of age.  See link for other in network organizations.

A number of out of network insurances are acceptable (B- level and above) (my rating.  These will be accepted in a standard way unless prior reimbursement history with this practice is problematic.  

There are a insurance companies not mentioned above that are ‘nominally in network’ as well as some out of network whose reimbursement practices are dishonest. One evident strategy is to undermine confidence in the foundation for reimbursement  by not paying claims.   They hope that the member will become worried or discouraged and discontinue counseling after a few visits.  Then, after months pass the entity may very well pay the balance due.  

If you suspect your insurance is of this variety and motivated for treatment, we can discuss ways to move forward that may include preemptive communications with the company and more.  Yes, I now have billing people to help facilitate claims and they may very well help bridge they gap, but in some cases may eventually ask your assistance (advocacy) to secure reimbursement.

If you have insurance that is not identified in this summary as “in network” and   not reasonably confident about using it for counseling with this provider, please email Karen Salmon or Ashleigh Weaver or contact 425-616-1496 (phone) or 360-668-5673 (fax). They can contact the insurance company and provide you with an interpretation of benefits.   

In any event, all potential patients and clients need to help control administrative costs by filling out all information required to process claims on intake forms.  This includes the date of birth, full name, address and other identifying information on yourself AND the primary holder of the policy.  Also, please fill out ALL credit card information on the Intake Form. If you are financially unable to follow through with this standard, please feel free to discuss your situation with me. 580-500-8050 or rsw@new-life-counseling-oklahoma.com

Sliding Scale: Self Pay & Marginally Insured Clients

Self pay clients / patients whose net, combined household income is less than than $80,000 annually are eligible for a Sliding Scale adjustment which is available as a drop down option on the Intake Form.  Since this establishes the ongoing rate of your billing, it is essential to be honest.

It is only feasible to offer this option to the community IF self directed honesty underscores its function.  Please call if you are insure about how to calculate this figure because it is not therapeutically advantageous to discuss this in a session. The lowest figures are established for people who are destitute, at or below the poverty line.  Please be honest and know that if I am unable to retain this generous format because of abuse of trust, some people may not have access to the help they need.

For most practical purposes, people with marginal insurance (i.e. very high deductible of more than $1000)  are ‘uninsured’ and may therefore fall into the self pay category — possibly self submitting paid invoices to the insurance company if a substantial amount accumulates in order to cover the deductible.  Generally, if such clients are accepted at a later date, I do not retro bill claims, but if she or he requests to engage as an insured patient from a given time forward, this may be possible if the insurance company engages properly from the onset.  Once the insurance is billed directly on a claim, the sliding scale rates are no longer applicable.

Credit Card On File