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Fees & Payment

INSURANCE

A Step Forward Counseling & Psychotherapy is considered an out of network provider with all insurances.

 

We take great pride in ensuring the highest level of care for our clients. It's important to note that many insurance companies offer out-of-network health benefits that clients might not be aware of and we are dedicated to providing information and guidance to help you navigate your insurance coverage effectively.

 

What does being an out-of-network provider entail? 

This means we do not bill insurance companies directly. Instead, you pay us directly, and at the end of the month, you receive a receipt or Superbill. This receipt can be submitted to your insurance for reimbursement if you have out-of-network benefits. Our goal is to empower you with the information needed to make the most of your insurance coverage while receiving the quality care you deserve.

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Our ASF Out of Network Benefits Guide

Benefits of Private Payment/Out-of-Pocket

 

The decision to involve your insurance company in your mental health care is entirely yours. Many clients opt not to involve their insurance company in their mental health care for the following reasons:

 

Limitations on Sessions and Therapy Type:

Health insurance may impose restrictions on the number of sessions and the type of therapy covered.

 

Mental Health Diagnosis Impact:

Insurance coverage typically requires a mental health diagnosis for therapy services. This diagnosis becomes a permanent part of your healthcare record and may have implications, such as potential denial for quality life or health insurance in the future.

How To Navigate Your Out-Of-Network (OON) Benefits

Start by calling the Member Services phone number on the back of your Insurance Card.

 

When inquiring about out-of-network mental health benefits, consider asking their insurance company the following questions:

Do I have out-of-network mental health coverage?

Determine whether your insurance plan includes coverage for mental health services obtained from out-of-network providers.

What is the reimbursement rate for out-of-network mental health services?

Inquire about the percentage of the cost that the insurance company will cover for out-of-network mental health services

 

Is there a deductible for out-of-network mental health services?

Understand if there is a deductible that needs to be met before the insurance coverage for out-of-network mental health services kicks in.

 

What is the out-of-pocket maximum for out-of-network mental health services?

Learn about the maximum amount you may have to pay out of pocket for out-of-network mental health services.

 

Are pre-authorizations required for out-of-network mental health services?

Check if the insurance company requires pre-authorization or approval before seeking out-of-network mental health services.

 

What documentation is needed for reimbursement?

Understand the specific documents or information required to submit a successful claim for reimbursement, such as superbill or receipts.

 

How can I submit claims for out-of-network mental health services?

Inquire about the process for submitting claims, whether it's done online, through mail, or using a specific platform.

 

Is there a time limit for submitting claims for out-of-network mental health services?

Understand if there is a deadline for submitting claims and ensure timely compliance with the insurance company's requirements.

 

Are there any restrictions on the types of mental health professionals covered?

Check if the insurance plan has any specific requirements or restrictions on the types of mental health professionals eligible for coverage.

 

What support services or resources are available for understanding out-of-network benefits?

Ask about available resources or support services that can help you better understand and navigate your out-of-network mental health benefits.

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Below are some CPT (Billing) Codes that an insurance representative might ask for:

 

In-Person CPT Codes:

90791 - Diagnostic Eval

90847 - Family/Couples Psychotherapy

90834 - Individual Psychotherapy

 

Telehealth CPT Codes:

90791 (95) - Diagnostic Eval

90847 (95) - Family/ Couples Psychotherapy

90834 (95) - Individual Psychotherapy

Terms your insurance might throw at you-

 

Deductible:

 A deductible is an annual fixed amount you must pay before your insurance coverage kicks in to share the costs of covered services.

 

Co-insurance: 

Coinsurance is the percentage of a claim that an insured individual is responsible for paying after the deductible has been met. This applies specifically to covered services, and you can find detailed information in your benefits booklet or by contacting your plan provider. Co-Insurance represents the shared financial responsibility between you and the insurance plan, typically expressed as a fixed percentage of the total cost of services. Ie: 75/25
 

Co-insurance vs Co-pays:

Copays, or copayments, are predetermined amounts you pay directly to your medical provider when you receive services. These copays vary for different types of services such as office visits, specialist visits, urgent care, emergency room visits, and prescriptions.
 

Out-of-Pocket: 

Once you reach your out-of-pocket maximum, your health insurance plan covers 100% of all covered services for the remainder of the year. It's worth noting that there may be separate out-of-pocket limits for individuals and families, similar to deductibles.

Superbills and How to Submit Your Claims

What is a Superbill?

A superbill is a detailed invoice provided by healthcare providers to patients, containing information about the services rendered during a visit. This document includes specifics such as diagnosis and procedure codes, dates of service, and itemized charges. Insurance companies use superbill information to process claims for reimbursement, as it provides a comprehensive breakdown of the medical services received by the patient.

 

Superbills at ASFCounseling:

In our office, upon request, we provide superbill statements on the first of every month via email.

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Submitting a Claim: 

Patients can submit claims to their insurance company either by mail or online through the insurance company's website. We recommend the online submission method as it provides an easier way to track and receive updates on the status of the claim. When completing the online submission, patients will be required to upload their superbill, ensuring that all necessary details are included for a streamlined and efficient reimbursement process. 

 

Need Help Submitting a Claim?:

www.Reimbursify.com

 

Reimbursify is a new platform that aids the process of submitting insurance claims for patients by empowering them to effortlessly self-file for out-of-network medical and mental health insurance reimbursement in as little as 10 seconds, providing a seamless and efficient solution for claim submissions.

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FEES

Our exceptional care and highly skilled therapists'

Psychotherapy Fees

Free initial 15 minute phone consultation. 

    

Intake Sessions

60mins - 210

Michelle Rizk

Laurie Weitzman

Dena Alalfey

Karol Espejo

Intake Sessions

45mins - 185

Mark Macauley

Alaina Kahn

Chelsea Wall

Reem Bechara

Micah Brady

Weekly sessions

45mins - 185                

                                                                                                      

A sliding scale (reduced fee) is available for those who qualify. 

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