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: Can I use the billing code Z63.0 Relationship Distress with Spouse or Intimate Partner
Answer: Yes. You can request that I use that billing code. This billing code focuses on both partners. Notes are written up to demonstrate how both partners are working on the relationship together. Insurance companies used to reject this billing code a lot. Some of them have been changing policies and are starting to accept that billing code. If you want to know if your insurance company accepts that billing code under your current plan, you would have to ask them.