Psychotherapy Fees & Insurance

Mental Health Insurance Filing

We have also partnered with Raleigh Counseling Collaborative for those who prefer to use their in network benefits.
Check with: Raleigh Counseling Collaborative about what insurance plans they accept.

I am currently only in network for Medcost. If I am not in network with your insurance plan, I can provide you with a receipt to file for reimbursement from your insurance plan (sometimes there is not a lot of difference between in network & out of network benefits).

I am currently an in network provider: counseling services

  • Medcost

You can use your Out of Network Benefits for*:

  • BCBS
  • UBH
  • Cigna
  • UBH
  • Aetna
  • Coventry
  • Tricare

As a result of the dramatic reduction in provider insurance reimbursement rates and the increasing costs to clients of in network benefits (so that you are paying most of the fees for our services anyway), I have chosen to leave insurance company' networks. I am now out of network for most insurance panels (see above list). If I am out of network, this means you can use your out of network benefits to see me. In my experience, out of network benefits are often not that different than in network benefits (see below for more information about out of network benefits).

*We do not take Medicare or Medicaid.

Using Your Out of Network Benefits: How this works is that you pay us whatever fee we agree on (To see our rates if paying for services outside of insurance, see below), we will give you a receipt to submit to insurance and they will reimburse you directly. If you would like us to file the claim for you, there will be a $7.00 charge per claim to cover the costs of our billing company’s services. However, we have found that when we submit the billing, that often this confuses the insurance company and they may randomly reimburse us, delaying payment to you. Usually it takes about three to four weeks for you to get reimbursement directly from the insurance company.

We welcome seeing you outside of your insurance, especially to ensure your medical records are kept private and allow us to decide what is best for you, not the insurance company. To see our rates if paying for services outside of insurance, click here. We understand that many people are experiencing financial hardship, so we do offer some limited reduction in our fees and have some reduced payment options. Please don't hesitate to contact us to discuss our fees. We make every effort to ensure you get the help you need.

Couples/Marital Therapy: Also, it is important to note that most insurance plans do not cover therapy that is primarily focused on your couple/marital relationship because relationship problems are not a diagnosable disorder and therefore are not seen as "medical necessity". In most plans, couples/marital therapy is an "exclusion". Therapists that say they can get insurance to cover couples therapy based on how they "code" the sessions, are doing something that is not only unethical, but potentially illegal (insurance fraud).

For more information see "a few words about insurance" below.

Fees for My Counseling Services

addictions

  • Individual Sessions:
    • Range from $120-$200
    • Cost will depend on length & type of session
  • Family/Couples Sessions:
    • Range from $150-$250.00
    • Cost will depend on length & type of session
  • Late Cancellation/Missed Appt - 75% of Rate for Scheduled Service
  • Groups fees vary (these are not covered by insurance)

* Since insurance is not involved, sessions lasting longer than 50 minutes are not unusual and many people that I work with find this flexibility to be helpful. We can talk about your needs and any financial concerns you may have, when we meet.

I accept and prefer personal checks, money orders and cash. I can also accept credit card* payments in my office or through Paypal. There may be a 2.28% processing fee for use of credit cards or Paypal. Just click "Pay Now" below to pay by credit card through Paypal. *

*Note: Paypal & the credit card processing company may not accept Flexible Spending cards. We would be happy to give you whatever receipt you need for your flex plan to get reimbursed for your payment to me for services.

For more information about fees and payment policies.

Information To Know About Fees

If sessions go over the time allotted, my fees are prorated so that each additional 10 minutes is $20.00 for individual sessions & $25.00 for family/couples sessions.

To avoid being charged for a missed session you must give 24 hour business notice. Since insurance does not cover missed appointments, it will be your responsibility to pay for this missed or late cancelled appointment.

Don't hesitate to talk with me about my rates. With insurance deductibles and copays dramatically increasing, my negotiated self pay rates may not be much more than the copay you would be required to pay if you used your insurance.

I understand that times are financially difficult for a lot of people. I offer 30 minute sessions at a reduced rate of $60.00 to accommodate those who are struggling financially. I have also joined Open Path Collective to make therapy more affordable to those who are financially struggling. To access my services at a reduced fee contact Open Path Collective at: http://www.openpathcollective.org There is never any pressure, so if we can't find a rate that is comfortable for you, I can refer you for help that might be more affordable.

For more information about appointments and scheduling policies and practices

Other services with related fees available upon request.

A Few Words About Insurance

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I recently decided to leave insurance panels. This was partly a financial decision, as insurance companies have continued to decrease reimbursement rates for providers and increase co-pays and deductibles for clients. This decision was also a clinical one, as managed care companies have continued to tightly manage benefits and I felt that having insurance involved was not in the best interests of clients and client care.As insurance has shifted a majority of the financial burden to clients, the limitations this places on services have outweighed the financial benefit to clients.

Working directly with clients, all decisions about treatment are between me and you, not to comply with insurance requirements. However, most importantly, my work with you will not penalize you as you seek medical care and/or insurance. In reporting services and having to meet the requirement of insurance companies, I must diagnose you with a mental illness requiring treatment. The insurance company uses this diagnosis to decide if therapy is considered "medical necessary" for them to pay for the services. This will be considered a "pre-existing condition" and will be used to determine the cost of insurance as you seek insurance in the future. I believe that getting help is hard enough. I don’t want this and our work together to cause you harm.

If I am no longer on your insurance panel, you may have "out of network benefits". However, this will mean you reporting to the insurance company that you are receiving treatment, a diagnosis will need to be given and they will decide if treatment is “medically necessary” (because, insurance companies use a medical model that says treatment is provided to a disease). Then based on this they will decide if they will reimburse you out of network. However, if you do not involve insurance at all and pay for counseling out of pocket, HIPAA protects your information and the insurance companies will have no knowledge or access to this information, unless you were to provide or give written persmission for this.

family therapy

Some Important Information About Out of Network Benefits: As insurance reimbursement rates to providers have not been raised in over 30 years, are now being lowered by up to 40% and client copays have continuously and dramatically been raised (to the point that insurance is paying sometimes 20% of services, leaving the client to pay the other 80%), many of us have been forced to leave the insurance networks. Not involving insurance, means that we are in charge of what you need, not what the insurance will allow and all of this is private, so we don't have to diagnose you and therefore giving you a pre-existing condition that impacts your insurability/insurance rates. So, for example, if you don't have a diagnosable condition, but just feel you need someone to talk to about relationship concerns and a 75 minute session is most helpful, we are free to do that. However, based on insurance medical necessity expectations, this would not be allowed. So, excluding the insurance company means we can meet your needs, not the insurance company's.

We may be able to check your Out of Network Benefits (OON). However, we cannot gaurantee the accuracy of the information and always suggest that you check these benefits, since insurance companies prefer to give this information to the member, rather than a provider who is not in their network. We always suggest that you check these benefits, since insurance companies prefer to give this information to the member, rather than a provider who is not in their network. In this climate of insurance increasing copays, it is possible that your OON benefits are not that different from your In Network Benefits. Sometimes, there is a deductible to meet (which can be the case with In Network benefits as well, depending on the plan) and many times there is not. Usually, OON benefits will cover a percentage of the "allowable rate". Unfortunately, insurance companies will often not share what this allowable rate is, but it is usually a range (with current insurance reimbursement rates at the very lowest end of these) called "reasonable and customary" or "usual and customary" rates. Many plans will cover 70-80% of these reasonable and customary rates, but we often have to guess what that range might be. So, if we charge $100 and insurance allows for up to $90 for that service and they reimburse at 70% of up to $90, after reimbursement, you would have paid $37 for the session.

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"What lies behind us and what lies before us are tiny matters compared to what lies within us".

- Anonymous