Individual Therapy

Question: Can I self pay for individual therapy?
Answer: Yes, the self pay discount is 100 dollars.

Question: How do I know if self pay is cheaper than using insurance?
Answer: Your insurance plan will let you know if the “deductible is waived for mental health” or if you have to pay the deductible first.

Question: Why do you charge the insurance company their full contracted amount and you give a discount to self pay?
Answer: I don’t always get to keep the money the insurance company gives me.

Question: What is a deductible?
Answer: The deductible is the amount that you pay before your insurance company will pay.

Question: What are co-insurance and co-payments
Answer: A co-insurance is a percentage of the bill that your insurance company will ask you to pay. A co-payment is a standard dollar amount that your insurance company will ask you to pay, each visit.

Question: Am I or my insurance company responsible for payment?
Answer: Insurance is filed as a courtesy, and does not guarantee payment for services. Outstanding balances are the client's responsibility.

Question: What insurance do you accept?
Answer: I am in-network with Aetna, Cigna, UnitedHealthcare (UMR, Optum), Blue Cross Blue Shield, and Ambetter (Home State Health).

Question: Do I have to have a mental disorder to use insurance?
Answer: Yes. Insurance will only pay if you are working on a diagnosable mental disorder. The most common are anxiety, depression, adjustment disorders, and post-traumatic stress. There are many other disorders all published in a book called the DSM-5

Question: Do you use a 3rd party-biller?
Answer: I use a third-party biller for Aetna, and Cigna. The third-party biller is named Headway. I use that biller for Aetna and Cigna because if I don’t they will pay significantly less on my claims.

Family/Couple’s Therapy

Question: Can I use my insurance for family/couples therapy?
Answer: Absolutely. To bill insurance for family/couple therapy, one of the participants needs to be working on resolving a mental health disorder. The chart is put under one name. The partner/family member is participating in therapy in an effort to help the person resolve the disorder. When the note is typed up, the record is about the person with the diagnosis and the details of the note demonstrate how all attendees are present to help the person alleviate the disorder.

Question: Is there a benefit to using self pay for family/couples therapy?
Answer: Yes. I can use the billing code Z63.0 Relationship Distress with Spouse or Intimate Partner. For parent/child therapy I can use the billing code Z62.820 Parent-Child Relational Problem. Although it’s not impossible, it is very improbable that the insurance will pay for that billing code. If you have the same last names, I can also put the chart under both names. Insurance companies do not like this. When I type up the record, I can focus on all participants in my notes. Insurance companies do not like the focus to be on all participants involved.