How much will it cost?? . . .
For most people cost is an important consideration. The fee is set based on a number of considerations including market rate, cost of providing good service in a comfortable environment, and a consideration of the cost to value for my clients. My fee is competitive in Chicagoland and I am happy to discuss fee and payment via phone or email prior to the first session.
I am an in-network provider for Blue Cross Blue Shield PPO plans and Medicare. Clients with these plans will pay the co-pay/co-insurance established for seeing in-network providers. If you have other insurance with out-of-network Benefits and elect to use them your insurance may reimburse you for a portion of the cost and you will be responsible for the remainder (co-pay or percentage). Therapy is considered a qualifying medical expense and therefore can be paid for using health saving accounts or medical flex funds.
Do you accept insurance?. . .
I am currently an in-network participating provider with Blue Cross Blue Shield PPO and Medicare. If you have Blue Cross Blue Shield PPO you will only pay the agreed upon co-payment/co-insurance once you have met any deductable. If you have Medicare Part B my services will be covered after co-payment based on the Medicare Part B plan and you may be able to use a supplemental coverage as well.
If you have other insurance through your work, school, or the insurance exchange my services are often eligible for reimbursement under the out-of-network benefits that are provided by most health insurance companies. Out-of-network benefits vary depending on plans but typically cover some percentage of the fee after you have reached the deductible. My fee typically falls well within the insurance companies’ acceptable range for psychologists. At this time, I have elected not be contracted or in-network with any insurance company. I am able to offer a lower fee due to the reduced administrative costs.
Is it complicated to file for out-of-network benefits?. . .
Many clients have used out-of-network benefits. I am committed to making this aspect of seeking services as simple for you as possible. Unlike many other providers I am willing to file out-of-network reimbursement paperwork on your behalf with your consent when possible. You will pay for services in full and will be reimbursed directly by your insurance provider. We will talk together about what information your insurance provider requires.
I recommend that you make initial contact with your insurance company prior to our first appointment to determine if you have out-of-network benefits and what percentage it covers. If you are considering using out-of-network benefits I am also happy to contact your insurance provider on your behalf to confirm your benefits.
Questions to ask your insurance about out-of-network benefits:
- What is the reimbursement rate for out-of-network outpatient mental health services?
- Do I have to meet a deductible? Is there an out of pocket max?
- Is there a yearly cap on reimbursement?
- What information do they require from you and from the provider to approve reimbursement?
What are the options for payment? . . .
I accept cash, check, or credit card. Unless you are using in-network benefits you will need to pay in full for sessions at the time of service. In rare cases such as university student insurance (e.g. Northwestern) that cover 100% of services minus a per session fee you may not be required to pay the full fee at time of service
Why are your services not in network for most insurance?. . .
There are a few reasons:
1) I am in the process of evaluating and applying for in-network participation with a select group of insurance plans. If I elect and am accepted I will become an in-network provider in the future.
2) Privacy and choice are very important to me. Insurance companies benefit consumers by using their large user base as leverage to negotiate lower costs for medical and mental health services. The greatest value of insurance is that it increases access to treatment for those who may otherwise be unable to afford it. However, by their nature insurance companies generally require their customers to allow certain access to information or input into their treatment planning (frequency or duration of sessions).
Whether your provider is in-network or out-of-network, insurance companies require a treatment provider to bill for a specific diagnosis. In many cases, a diagnosis is appropriate but for those seeking support with typical life stressors or recent life changes it may result in a premature or inaccurate diagnosis that becomes part of your permanent medical record. Insurance companies are also increasingly incentivizing their providers to participate in electronic health information exchanges (HIE). If enrolled, the diagnosis along with information about length and dates of sessions could become part of a healthcare information database accessible to other health professionals. I want to refer you to privacyrights.org to learn more about your rights regarding your medical and mental health information.
Information can be accessed in the future by employers if you or your child is seeking a job that requires you to submit to a comprehensive background check. This is true for jobs that require security clearance or involve responsibility for the well-being of the public (such as pilot or government contracting). It can also be used for determining individual health insurance rates and life insurance rates.
Many insurance companies place a cap on the number sessions of counseling that their customers can receive from in-network providers. If you and I were to agree to continue beyond the approved limit it would require petitioning the company and providing justification to continue benefits. I prefer that treatment decisions are made collaboratively by the two of us. I would be happy to answer any additional questions you have about insurance benefits.
Would I consider joining insurance networks in the future?. . .
There are insurance companies who offer better protections and increased choice for their customers. I am open to exploring or pursuing becoming an in-network provider and would inform you ahead of time of any changes in my business practice. If I were to become an in-network provider for you insurance company I would be required to honor the fee/co-payment policies of your network.