COUNSELING IN CARY, GARNER OR TELE HEALTH, STATE WIDE- NC
Insurance Counseling Fees
In-Network providers for the following insurance companies:
*Ambetter - In-network practice wide
*Blue Cross Blue Shield (NO Blue value or Local) - In-network practice wide
*Blue Home UNC Alliance - In-network practice wide
*Aetna (including SHP) - In-network practice wide
*Medcost - In-network practice wide
*United Behavioral Health (UBH)/ Optum (Select providers in network)
*Cigna (Select providers in network)
Please note that insurance providers typically do not cover marriage or couples counseling services. Consequently, these services are categorized as “self pay” fees and may require a good faith estimate prior to service.
SELF PAY FEES
Intake (First session) -$195.00; Individual sessions (45-55 min) $145.00; Couples/ Families $165.00
Please note that insurance providers typically do not cover marriage or couples counseling services. Consequently, these services are categorized as “self pay” fees and may require a good faith estimate prior to service.
GOOD FAITH ESTIMATE
Effective 1/1/2022, the No Suprise Act requires all healthcare providers (including mental health therapists) to provide a Good Faith Estimate if you are un-insured or choose not to use your insurance to cover your services.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-877-696-6775.
HELPFUL QUESTIONS TO ASK WHEN CONTACTING YOUR INSURANCE COMPANY
- Is outpatient mental health counseling covered under my plan?
- Is the therapist I want to see in-network?
- Do I need a referral from my primary care doctor?
- Is prior authorization or pre-certification required before starting therapy?
- What is my deductible for mental health services, and how much have I already met?
- What is my copay or coinsurance for each session?
- Are telehealth or virtual counseling visits covered, and are they billed the same as in-person visits?
- How many sessions are covered per year, and are there any dollar or visit limits?
- Do I have out-of-network benefits, and how much would I be reimbursed?
- If I pay upfront, can I submit a superbill for reimbursement?
