Paying For Psychotherapy
Psychotherapy is a commitment to your health and well being. The financial cost is similar in importance to other choices that improve the quality of your life such as education, medical procedures, career training, or vacations. You should consider the cost of counseling in light of your monthly bills, your income and insurance coverage.
And it is important that we discuss finances just like we discuss any other topic in counseling.
Regardless of how you pay for counseling, I will provide you with a financial statement at the end of each month for your records. This statement may be helpful as you plan your monthly budget, determine your income tax deductions in April, or submit to employer-sponsored medical deferment/reimbursement programs such as HSAs, FSAs, etc.
Self-Payment vs Insurance Filing
According to HIPAA laws, if you pay my full fee – and do not rely on insurance or other 3rd party payors – you maintain the most control over your privacy. We will discuss the exceptions to complete confidentiality during our first meeting before you disclose personal information in-depth.
Every employer issued policy has unique provisions, and there are policies with variable provisions offered over the Illinois ACA Exchange.
It is important to research your benefits before you begin counseling. This research will inform you what your actual out-of-pocket cost will be. Please contact your insurer at the telephone number on the back of your card and ask the following questions before meeting with me:
What is your coverage Effective Date? Do you have a waiting period for coverage for any reason?
What is your annual deductible, and how much has been satisfied at the time you call your insurer? Does your policy “carve out” counseling to another company; if it does, must you satisfy a separate annual deductible for CPT codes 90834 and 90837?
What is your policy’s copay (a fixed dollar amount) or coinsurance (a percentage) for each appointment? What is your insurer’s “usual and customary” reimbursement for CPT codes 90834 and 90837?
Must you request pre-authorization of sessions, either in the beginning of treatment or after attending a specific number of appointments?
It is important to recognize that your insurance policy may have coverage limitations that do not coincide with the frequency or duration of treatment that is best for you. In this case, you will be financially responsible for all services not covered by your insurance policy.
Blue Cross / Blue Shield of Illinois (BCBS/IL) PPO
Currently, I am an in-network panel provider for BCBS/ILLINOIS-PPO/POS and Blue Choice policies and I will accept the contract provisions of any BCBS-PPO policy that provides adequate reimbursement within a 30 day period following claim submission. I will submit claims on your behalf to BCBS/IL and accept assignment from BCBS/IL. BCBS policies based in other US states typically cover my services when you attend sessions in Illinois, but sometimes have different conditions. Thus, it is important that you telephone your membership office prior to beginning counseling to know your policy coverage.
Please note that I am not a BCBS-HMO provider and my services will not be covered under any BCBS-HMO policies for any services; you will need to pay out-of-pocket to work with me if you have a BCBS HMO policy.
Other Insurers and Policies
It may actually be beneficial to you if I am an “out-of-network” provider with your insurer because I am not under contract.
If you have a PPO or Indemnity policy underwritten by another insurer — e.g. CIGNA, AETNA, UNITED HEALTH CARE, UNITED BEHAVIORAL HEALTH, GUARDIAN, Principal, and most other insurers — your work with me should be reimbursed on an “out-of-network” basis. In this situation, I will ask you to pay me at each session but will give you a completed claim form at month end that directs your insurer to reimburse you directly. You need only to sign and mail the claim form to the address on the back of your card.
If I am “out-of-network” with your insurer, we can discuss options if you find your benefits for psychotherapy financially burden your monthly budget. Additionally, you may choose to submit the claim or not, i.e. it is completely your choice to file with your insurer.
I am neither a MEDICARE, a MEDICAID, TRICARE nor an HMO provider with any insurer. These policies will not reimburse your treatment with me.
If you are eligible for Medicare coverage, both you and I must “opt-out” of the Medicare program if you wish to work with me.
Call 847-570-0817 for an initial consultation.
Illinois Licensed Clinical Psychologist seeing clients in downtown Chicago (60602) and Park Ridge (60068).