Individual Therapy

Question: Can I self pay for individual therapy?
Answer: Yes, self pay 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: 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 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-V

Question: Do you use a 3rd party-biller?
Answer: I use a third-party biller for Aetna, and Cigna. Through this third-party biller, you can find out about your deductible and copay ahead of time. Use this link to determine what your insurance will cover and if I am in-network with your insurance.

Family/Couple’s Therapy

Question:
Can I use my insurance for family/couples therapy?
Answer:
For couple’s therapy, I’m going to use the billing code Z63.0 Relationship Distress with Spouse or Intimate Partner
For parent/child therapy I’m going to 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.
I’m also going to attempt to put both names on the chart. This will make it impossible to bill insurance.
When I type up the record, I’m going to focus on all participants in my notes. This is not how a note is typed when using insurance.

Question:
Do other clinics use 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 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. You are welcome to find another clinic that will do this for you.