Payment & Insurance FAQs
Payment & Insurance for Therapy Services
How does payment for therapy services work?
We are a self-pay practice, which means that all clients pay us directly for services. Payment is due in advance or at the time of services. We will go over the details with you. In some cases, you may be able to use your insurance plan for reimbursement.
Can I use my insurance?
In some cases, yes. We are not providers on any insurance plans, so we are considered out-of-network providers for all insurance companies. Some insurance plans allow you to use out-of-network providers and some don’t. You will need to contact your insurance company directly to find out if you have an out-of-network benefit. If you do, you will still pay us directly, and will need to ask your insurance company how to get reimbursement. We do not bill any insurances directly.
Questions to ask your insurance company:
- First ask your insurance company if your plan lets you see out-of-network providers for mental health therapy.
- If you DO have an out-of-network benefit, ask what you need to do to get reimbursed if you pay a therapist directly for services.
- Ask if the insurance company can give you an idea of how much reimbursement you can expect.
- You will also want to ask if you have a deductible, how much it is, and whether it’s different for out-of-network services or mental health services.
We will give you the statements you need, called Superbills, to submit to your insurance company with all the relevant information to help you get reimbursed.
Are there reasons I would not want to use insurance?
Some people choose not to use their insurance even when they have benefits that would provide reimbursement. Insurances typically cover only services that are considered medically necessary. This put some limitations on how and when insurance can be used. It almost always means that a mental health or substance abuse diagnosis must be given for insurance to cover services. Maintaining as much privacy for personal health information is another reason some people choose to not use insurance payments.
Do you provide receipts or statements?
Yes, we can provide several types of statements, depending on the purpose you need them for, whether it’s insurance or to receive reimbursement from other sources, for tax purposes, or for your own record-keeping.
What types of payment do you accept?
We accept payment by credit cards. We can keep credit cards on file securely for convenience. Some clients use HSA (health savings plans) or FSA (flexible savings accounts) to pay for therapy services. Other payment arrangements can be discussed.
Can I use my HSA (health savings plan) or an FSA (flexible spending account) to pay for therapy?
Yes. If you have an HSA or FSA, you can use it to pay for therapy.
Do you have any discounts?
We do maintain a limited number of discount slots for people who cannot get reimbursement from their insurance companies and cannot afford to pay our normal rates, but are eager to find a way to invest in working with us. Please ask us about this option if you think it might be important for you.
Notice of Good Faith Estimate for Health Care Items and Services
Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.
Note: The PHSA and the GFE does not apply currently to any clients who are using insurance benets, including Out of Network Benefits (seeking reimbursement from your insurance companies).
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises
I Want to Know More
I have more questions. How can I get answers?
Great! We are happy to answer your questions. Please call 413.644.0171, use the message form below, or email email@example.com to get in touch.