Insurance & Cost
In-Network Insurance Plans
We are currently in-network with the following:
- AllOneHealth EAP
- Anthem BlueCross BlueShield
- Cigna EAP
- Optum EAP
- United Healthcare | UHC
- United Medical Resources | UMR
- WellSpring EAP
In-network insurance plans vary by the clinician. You are responsible for confirming that your plan covers telehealth sessions with your specific therapist. If you use insurance, your payment will depend on your specific plan. You are responsible for verifying your coverage and confirming the details of your copay, coinsurance, and deductible. Your portion of the payment is due at the time of service.
Even if we’re out of network, your insurance may still cover all or a portion of your counseling sessions. The difference is that they reimburse you directly instead of us. We can easily provide you with paperwork (“superbill”) for you to claim out-of-network benefits from an insurance company not listed above.
We will soon be in-network with the following:
- Medicaid (Ohio)
- Medical Mutual
- United Healthcare Community Plan
A $99 fee will be charged for all appointments that are not canceled within 24 hours of the scheduled session start time.
Information for Self-Pay
We accept cash-pay clients at a rate of $175 for the initial assessment and $150 for each session following. We can also provide superbills that can be provided to insurance companies for reimbursement.
The No Surprises Act is a federal law that gives you the right to a good faith estimate of the cost of services at this practice. However, Ohio licensing board rules require clinicians to provide you with the actual cost of charges in a written informed consent form to which you must agree before receiving services. That will be available to you before you are seen for services and before any billing. In most cases, estimating how many sessions you will need is impossible. That will not be determined until your concerns are evaluated and will also vary based on the progress you make, which depends in part on your efforts with the process. You will be free to discontinue services at any time or the services may otherwise be terminated in accordance with the informed consent form language.
The No Surprises Law states that you may initiate a dispute process if the actual charges are substantially in excess of the Good Faith Estimate charges, i.e., if you are charged $400 more than the estimated cost for a session or the total estimate provided. That is unlikely to happen and would be a violation of licensing board rules since you will agree up front to actual charges per session prior to being seen. Dispute information is available upon request, however. Any changes to fees will require a change in the informed consent form fees, which you must agree to prior to having them go into effect. Otherwise, the fees will remain in effect for 12 months.
Benefits of Self-Pay
Without restrictions, you may find the ideal therapist for you. One of the key elements for successful treatment outcomes is the relationship you have with your therapist. You can locate a highly skilled therapist with whom you feel comfortable without overcoming the insurance hurdle. You require an expert for your various bodily health issues, just as you require one for your various emotional issues. Finding a therapist “who gets it,” as well as one who can assist you in getting “out of it,” is crucial. You and your therapist completely control the therapy and treatment decisions. Insurance companies set restrictions on how much therapy you may receive, how frequently, and how long sessions can last using their own internal rules (which are not supported by any evidence or study concerning treatment). Ideally, you and your therapist should decide on your course of therapy. When utilizing insurance, insurance can discontinue paying for treatment sessions.
You can utilize your Flexible Spending Account (FSA) or Health Savings Account (HSA). Private payment offers significantly greater privacy. Having insurance does not ensure your privacy. Your insurance provider does not promise to keep your most private information private. Claim processing involves a large number of parties and departments. Therapists must frequently provide insurance companies with client information to support therapy. Not just for illnesses but also for mental wellbeing, you may get treatment. People seek therapy for a wide range of legitimate reasons that insurance does not cover, including personal development and exploration, emotional health and welfare, self-care, mental health prevention, strengthening bonds with others, enhancing sexual wellness, and more. Insurance mandates “medical necessity” for therapy, and therapists must substantiate this to the insurance company to pay for care. If there isn’t a forced diagnosis of mental illness, there is also no diagnosis on your medical file. We may discuss this and determine what works best if a certain diagnosis is essential to you. Not everyone, though, qualifies for a mental health diagnosis. Many of our clients don’t. Insurance companies require a diagnosis even if there isn’t one and will only pay for particular disorders to fund mental health therapy.