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You choose the psychiatric provider you think is best fit for you. You are not limited to the insurance panel options.
Many health insurance companies require that every client be diagnosed with a specific mental health condition in order to receive treatment or have your treatment covered. To be approved for therapy, the therapist must make a case that therapy is "medically necessary" which involves labeling the client with a mental health diagnosis. This is often required after the first visit, and then becomes part of the client's permanent health record. In addition to this, health insrance companies usually limit you to discussing only issues that pertain directly to your diagnosis. Unfortunately, this sometimes means that insurance companies won't cover issues you may need to address (such as relationship or work issues). Private pay psychiatric provider don't need to provide a diagnosis in order to provide services. Therefore, a private pay provider is able to work with you on any presenting issue.
You aren't restricted to a certain number of sessions.
Your psychiatric provider has the freedom and flexibility to think outside the box and engage in therapy options that may not be approved by health insurance companies.
Your mental heath records won't be used against you. All psychiatric healthcare providers are required by federal law to keep confidential records. When you choose to use your insurance company, your psychiatric provider must ask you to sign a waiver that allows them to communicate this confidential information to your insurance company. This confidential information includes dates of service and a mental health diagnosis. In the event your insurance company requires preauthorization for treatment and/or reviews your file, additional information, such as therapy session notes must be provided to your insurance company.
GENERALLY, I DO NOT BELIEVE THIS IS IN THE BEST INTEREST OF THE PATIENT
Something else to consider is that this information becomes part of your record and could be used by insurance companies to raise your rates,
as well as prevent you from obtaining life insurance or disability insurance. It could also prevent you from obtaining private health
insurance should you make the decision to become self-employed in the future.
Importantly, the personal details of therapy are often entered into a database called the Medical Information Bureau (MIB) by your insurance company. The medical information of millions of people is currently housed in this database. Other providers, insurance companies and even
non-medical services like personnel departments may have access to this information for the purposes of evaluating you and negotiating corporate group rates.
OUT-OF-NETWORK PROVIDER OPTIONS:
If you want to choose your own psychiatric provider but would like to use your benefits, you can pursue an out-of-network psychiatric provider.
If you have a high deductible plan or good out-of-network benefits, you may actually find it more affordable or comparable in cost to use your
A deductible is the amount you have to pay up-front before your insurance coverage kicks in. If you have a &7000 deductible and you have not
yet had any other medical expenses for the year, you are responsible for paying $7000 in mental health or other healthcare fees, out-of-pocket, before your standard co-pay applies (a co-pay may vary from $25-75 a visit, depending on your specific plan).
However, if you have good out-of-network benefits, your insurance company may reimburse you as much as 80% of each session fee,
depending on your plan. This means that in some situations, using your out-of-network benefits can actually be more affordable or comparable
to your standard copay to see an in-network psychiatric provider.
Summary: This office does not currently accept any insurance in part to the increasing request of insurance companies to collect information
we believe to be confidential and not always in our patient's best interest. However, we will be glad to complete and provide you with the required insurance forms (CMA-1500) so that you may submit to your insurance for out-of-network reimbursement and/or that it may count toward your deductible. We suggest you check with your insurance ahead of time to see if this is manageable for you.
Payment:We do accept cash, credit cards, Health Spending Account Cards (HSA) and checks. I use "Square" with encrypted technology and is HIPAA compliant as well as compliant with federal mandates for storing credit card data. Your credit card information is not stored anywhere in your chart. Payment is required at time of service. Multiple credit card declines (this does not include expired cards where your information just needs to be updated in our system) will require an alternate form of payment. Returned checks will incur a $25 returned check fee and an alternate form of payment.
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