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.
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 firstname.lastname@example.org
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.
Patients are expected to provide complete credit card information for billing copayments and deductibles immediately after claims are processed. Those being served through a sliding scale are expected to have a VALID card on file with sufficient funds at all times. If an EAP client believes he or she will wish to continue counseling after the EAP term is complete, then please include your credit card at intake. Medicare clients should include credit card at intake to cover copayments and deductables. Medicare/Medicaid and Soonercare patients are not required to add credit card information.
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.
Cancellations less than 24 hours before appointment will incur a late cancellation fee of $30 automatically billed to credit card. No shows without prior communication will be billed $50.
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). If possible, my tendency is to attempt to offer these services when it is feasible to do so in a way that is fair, reasonable and mutually beneficial.
For a time until very recently, some of the better insurance companies paid on extended session codes, but at present they have almost entirely disengaged from accepting claims with extended codes. 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 services for which no assignment (no payment is offered) because the service, though very real and perhaps very critical is not recognized.
Each patient is in a different situation. If you think you will probably benefit most from longer sessions and wonder what kind of accommodations might be made, please fill out this form so that at some point early in our relationship… perhaps before, during or after first visit or two – please fill out the this linked EXTENDED SESSION QUESTIONNAIRE.
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.