|Fees & Insurance Coverage|
Most charges are based upon your therapist's hourly fee, although some services, such as group psychotherapy or psychological testing, may be billed at a set fee.
The hourly fee is generally charged, on a prorated basis, for professional services other than the typical hour psychotherapy session. These may include extended sessions, report writing, telephone consultations, emergency on-call contacts, atttendance at meetings or consultation with other professionals which you have authorized, preparation of records or treatment summaries, or the time required to perform any other professional service which you request.
You will be billed for unkept psychotherapy session appointments unless they are canceled 24 hours in advance, or unless you and your therapist are in agreement that you were unable to attend due to circumstances beyond your control.
If you become involved in litigation which requires the participation of your therapist, you will be expected to pay for professional time required even if your therapist is compelled to testify by another party. Because of the complexity and difficulty of legal involvement, per hour charge for preparation and attendance at any legal proceeding may be higher than your therapist's usual clinical fee.
If your circumstances require that your therapist travel away from the office to provide professional services, the hourly fee will include travel time and a mileage fee will also be assessed.
Insufficient fund checks, authorization-refused bank cards, and balances older than 28 days are subject to service charges.
Payment in full at time services are rendered is preferred, unless you and your therapist have agreed otherwise or unless you have insurance coverage which requires another arrangement. At your request, our office staff will bill you monthly. Our accounting cycle ends on the last day of each month and payment in full is due by the 15th of the following month.
We recognize that temporary financial problems may effect timely payment of your account. If such problems do arise, you are encouraged to contact your therapist or our office staff promptly for assistance in development of a plan-of-payment contract.
If your account is more than 60 days in arrears and suitable arrangements for payment have not been agreed to, your therapist may provide you with notice of termination of care and refer you to alternative treatment resources.
If your account is more than 60 days in arrears and suitable arrangements for payment have not been agreed to, Psychotherapy Associates has the option of using legal means to secure payment, including collection agencies or small claims court. If such legal action is necessary, the costs which bringing that proceeding will be included in the claim.
In order for your therapist and you to set realistic treatment goals and priorities, it is important to evaluate what resources are available to pay for your treatment.
If you have a health insurance policy, it may provide some coverage for mental health treatment. However, your health insurance is a contract between you and your insurance carrier--a contract to which Psychotherapy Associates is not a party. While assistance in completion of insurance claim forms is a courtesy we extend to our patients, all charges are your responsibility from the date services are rendered.
Some insurance plans require prior authourization from their reviewers; some cover only services provided by clinicians with whom the plan has a contract; some select certain services for exclusion; some limit or exclude all mental health treatment; some require physician referral, supervision, or case review. It is your responsibility to be familiar with the requirements and limitations of your policy. If your policy requires special procedures, such as physician review of your treatment plan, we may be able to assist you in making required arrangements but must be informed of your special needs prior to the first visit.
You are encouraged to carefully read the section in your insurance coverage booklet which describes mental health services. If you have questions, please direct your inquiries to your plan administrator. Our office staff will do their best to try to assist you in deciphering the information you receive from your carrier.
Our office staff will be happy to submit insurance claims on your behalf. Any such request must be accompanied by a photocopy of your insurance identification card and all information required by your insurance carrier prior to your first visit. A Universal Health Insurance Claim form, accepted by all major insurance carriers, will be submitted on a monthly basis at the end of the accounting cycle. This service is provided at no charge, although requests for duplicate claims and statements are subject to an accounting service charge.
Managed care plans
The escalation of the cost of health care has resulted in an increasing level of complexity about insurance benefits which sometimes makes it difficult to determine exactly how much mental health coverage is available. Managed health care plans such as HMOs and PPOs often require advance authorization before they will provide reimbursement for mental health services. These plans are often oriented towards a short term treatment approach designed to resolve specific problems that are interfering with one's usual level of functioning. It may be necessary to seek additional approval after a certain number of sessions.
In our experience, while much can be accomplished in short term therapy, many patients feel that more services are necessary after insurance benefits expire. Some managed care plans will not allow your therapist to provide services to you after your benefits are no longer available. If this is the case, your therapist will refer you to another therapist who will help you continue your treatment.