Generally, with the possible exception of clients who pay cash or check each visit, there are no monetary transactions at the time of a session. Unless requested otherwise, patients are generally not billed for coinsurance or deductible until after a claim is processed and patient’s share is enumerated. At that point, in the absence of other arrangement(s), payment from a credit/debit card on file is required.
This practice is in network with Blue Cross/Blue Shield, BlueLincs, HealthChoice, OptumHealth (formerly United), Medicare, Medicaid as a Medicare supplement and Medicaid (Soonercare) for children/teens under 21 years of age. See link for other payers and note that even if your company is not included, most out of network insurances are acceptable.
If you have doubts about your insurance or unsure what the reimbursement for counseling services will be, feel free to contact contact Rick or Mark with MD Admins at 401-437-4337. They can investigate your standing with your insurance company and provide information about the coverage.
All patients and clients are asked to provide the required information to process claims on Intake Forms. This includes the date of birth, full name, address and other identifying information on yourself and if applicable, also the primary holder of the policy.
Please fill out ALL credit card information on the Intake Form. If you are unable to provide a credit card or experiencing severe financial problems, please feel free to discuss your situation. Contact 580-500-8050 or email@example.com
Self pay clients / patients whose household income is less than than $80,000 annually are eligible for a Sliding Scale adjustment which is available as a drop down option within the Intake Form that can be accessed and filled out online and submitted. Since this establishes the ongoing rate of your billing, it is essential to be honest.
NOTE — It is only feasible to offer this option to the community IF self directed honesty routinely 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 or to give a false figure for income and then have the truth emerge down the road during therapy. AGAIN, FROM THE ONSET, 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 quality help they need.
Clients with marginal insurance (i.e. very high deductible of $2000 or more) as well as much less than 80,000 household income might decide to be aligned as ‘uninsured’ and may therefore fall into the self pay category — possibly self submitting paid invoices to the insurance company to cover the deductible or for other reason. If such clients decide to shift to requesting that claims are filed, it is not correct to retro bill claims at the standard rates higher than the sliding scale rate, but from the time she or he requests to engage as an insured patient, then standard claim rates, co-payments and deductible apply. From the time insurance is billed directly for a claim, the sliding scale rates are no longer applicable.
At the time of intake, patients are expected to provide (place on form) complete credit card information for this practice to auto charge co-payments and deductibles. These charges will occur when claims are processed or very soon after a self pay session is conducted. These patients as well as those being served through a sliding scale are expected to have a VALID card on file with sufficient funds at all times.
EAP clients will not be charged until the authorized sessions are complete and he or she have attended an insured or self pay session. They are asked to post credit card at the time the intake form(s) are filled out before the intake session occurs.
Medicare patients should include credit card information when completing online intake in order to cover co-payments and deductibles. Those with combined Medicare/Medicaid or other supplement and Soonercare (Medicaid) patients (only those under 21) will not be billed for services, but they should also place credit card information on file to cover charges for late cancellations and no shows that apply to all patients /clients.
Please understand that I reserve MUCH more time per session for clients than held for a typical doctor’s appointment. In order to at least partially recoup losses, I retain the option to charge $30 for cancellations (made less than 24 hours in advance) and $50 for no shows. Thank you for understanding
Extended sessions are a complex and sensitive matter. For a long list of reasons many clients require more than a standard one hour session(s). Under certain circumstances the practice is to offer these services for an additional fee in addition to standard claims processing.
For a time until very recently, some of the better insurance companies paid on extended session codes, but at present, aside from crisis codes, they have disengaged from accepting claims with codes for additional time. In other words, in the mental health arena, they generally do not merely not pay on the main code and reject the second for extended time, they simply pay for nothing unless a claim is submitted without a code indicating an extended session.
“Accepting assignment” means the provider agrees to accept what the insurance pays on a billable services and does not surprise a patient with additional charges he or she does not expect. Accepting assignment does not or should not apply to extra services for which no assignment (no insurance payment) is offered. If we mutually agree that your condition calls for extended sessions, then we may need to communicate about compensation in addition to standard insurance reimbursement that covers only the first hour – $90 per hour or $45 per half hour is the standard rate for 2023.
Please note that components of extended sessions outside the hour covered by insurance should NEVER be submitted to insurance! These are billed soon after as session, even before the claim for the reimbursable component has been submitted to insurance.
After you register a tentative appointment through the booking app below, it is necessary to complete the Intake Forms. In this way, when we meet we can focus on counseling rather than paperwork. Please do a good job on these forms! Be sure to retain the email and password used to access in the event it is necessary to finish a section at some time in the future.
Below, you may choose your “location” of service which includes a teleconference option. If you need a time not listed as available, please contact me to see what accommodations might be made. All sessions scheduled on this menu are subject to confirmation or adjustment which should occur within a reasonable period of time after you make your selection. In any event, feel free to leave a message or possibly make contact with me right away: 580-500-8050.