Services Provided
Insurance
I am not in network with any insurance provider. Many people are unaware of the risks to privacy and confidentiality associated with billing health insurance, nor the potential consequences of such disclosure, such as negative impacts on employment or ability to obtain health or life insurance. This risk is associated with the input of your mental health information into national insurance companies' systems, which can then be reported to the national medical databases, such as the National Medical Data Bank or the National Practitioner Data Bank. Information in these national data banks is susceptible to security breaches, unauthorized access, and mishandling or misuse. Exceptions in HIPAA also authorize access to certain medical information to law enforcement, which can potentially lead to mishandling, misuse, or discrimination.
Out-of-Network Reimbursement
Based on your insurance plan, you may qualify for out-of-network reimbursement. Plans with this coverage may reimburse a lower percentage of the claim than is paid to in-network providers, and reimbursement rates can fall between 25% and 90% of the claim. Some plans also have a deductible for out-of-network services that will need to be met separately from your in-network deductible. Be aware that insurance companies will often request copies of psychotherapy progress notes in order to process claims, and your files can be subject to audits, just as with in-network providers. Out-of-network reimbursement requires the same disclosures of confidential information and carries the same risks as outlined above.
I use a company named Thrizer to make services more accessible and affordable for my clients. Thrizer also streamlines the out-of-network benefits process for you, which can be confusing and frustrating to navigate. Here's how it works: I submit your payment through the secure Thrizer app, which will automatically generate the claim to your insurance company. Perhaps even better than the lack of need for superbills and submitting your own claims is that you can either choose to pay your bill in-full and wait for reimbursement via direct deposit from Thrizer, OR you can pay only your coinsurance amount and Thrizer will cover the remainder of your bill and wait for their own reimbursement from your insurance company! If you decide to wait for your own reimbursement, Thrizer will only charge an additional 1% of my fee ($1.50/individual session & $2.00/couples). If you want to only pay your copay and have Thrizer pay the remainder and wait for the reimbursement from your insurance, they will take an additional 5% of my fee ($7.50/individual session & $10.00/couples) almost like interest on a loan -- Ahh! The cost of convenience! Oh- and they will not charge you back payments in the case of a denial, and they will work with you to resolve the reasons for any denials. Thrizer also has a benefits calculator within their portal and I can get a real-time breakdown of your out-of-network benefits and your estimated co-insurance rate so you know before we start sessions exactly what they will cost you! Click here to learn more about your supportive options through Thrizer.
Good Faith Estimates
January 1, 2022 a federal law, called the “No Surprises Act”, went into effect to protect patients from unexpected medical bills. This law requires healthcare providers to produce a “Good Faith Estimate” (GFE) outlining anticipated costs of services to patients who are uninsured or choose to self-pay (and not seeking to file a claim for the service with their insurance). It does not apply to those seeking reimbursement for out-of-network benefits with their insurance provider, even if you are paying towards an out-of-network deductible. The GFE is based on the preliminary information gathered by the provider, and is subject to change due to unforeseen complications or special circumstances. If such changes in treatment protocols create an increased financial obligation for you, you will be provided an updated GFE based on the new treatment protocol. If increased charges occurred without a discussion with your provider and updated GFE, you have the right to dispute the bill under this federal law. Providers are required to communicate this GFE to you, both orally and in-writing, upon your request, no later than 3 business days after scheduling an appointment 10 business days out, and no later than 1 business day after scheduling an appointment between 3 and 9 days out.