COST AND INSURANCE
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.
If you have insurance benefits and elect to use them your insurance will pay 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?
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 also 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. 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 to your insurance company prior to our first appointment to determine if you have out-of-network benefits and what percentage it covers. If you decide to use out-of-network benefits I am also happy to contact your insurance provider on your behalf after our first appointment to confirm your benefits.
Questions to ask your insurance about out-of-network benefits:
- 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 the provider to approve reimbursement?
What are the options for payment?
I accept cash, check, or credit card. Typically clients play in full for sessions at the time of service.
Why are your services not in network?
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 forfeit certain access to information or input into their treatment planning (frequency or duration of sessions). For many the disadvantages outweigh the benefits when it comes to their mental health.
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 [https://www.privacyrights.org/content/introduction-health-and-medical-information-privacy] to learn more about your rights regarding your medical and mental health information.
Information this is available in medical databases 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 agreed 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 and would prefer not to provide evidence (broadly or otherwise) for our decision to an outside party in the name of cost containment. 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. While there are still some drawbacks, I would be 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.
What can I expect at the first session?
See Getting Started and What to expect at first session.