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, required or elected medical procedures, career training, or vacations. In some situations, committing to counseling can be as essential as food and housing.
You and I can discuss finances just like we discuss any other topic in counseling. You should consider counseling in light of your monthly bills, your income and insurance coverage. We will discuss the cost of treatment if your financial situation changes during your work with me.
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. That is, your counseling will be completely confidential unless you choose to release information, or if you indicate a plan to harm yourself or another person, or demonstrate an inability to take care of yourself. 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 Exchange.
Your health insurance probably includes coverage for psychotherapy, but 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 any reason?
What is your annual deductible, and how much has been satisfied at the time you call your insurer?
What is your policy’s appointment copay (a fixed dollar amount) or coinsurance (a percentage of your
insurer’s “usual and customary” reimbursement)?
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.
I will discuss any insurer requests with you before I release any information about you. If your insurer requires the completion of an authorization form before counseling appointments will be reimbursed, you and I can complete the form together.
Blue Cross / Blue Shield of Illinois (BCBS/IL) PPO
Currently, I am an in-network panel provider for BCBS/ILLINOIS-PPO/POS 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 offices, but sometimes have different conditions. Thus, it is important that you telephone your membership office prior to beginning counseling to know your policy coverage.
In addition, I am considered an “in-network” provider for BCBS-Blue Choice plans as of 1/2016. However, my continued participation as a panel provider for Blue Choice policies will be determined by the participating hospitals and BCBS-Blue Choice reimbursements for counseling in 2016.
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 more beneficial to you if I am not an “in-network” provider with your insurer.
If you have a PPO or Indemnity policy underwritten by another insurer — e.g. CIGNA, AETNA, UNITED HEALTH CARE, UNITED BEHAVIORAL HEALTH, GUARDIAN, Principal, 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.
In this situation, we can discuss finances if your insurer provides inadequate coverage for my services. Additionally, you may choose to submit the claim or not, ie it is completely your choice to file with your insurer. Should your insurer require forms to authorize your treatment, you and I can review the information before I release it to your insurer.
I am neither a MEDICARE, a MEDICAID, nor an HMO provider with any insurer.These policies will not reimburse your treatment with me so you will be financially responsible for all fees.
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. You will be responsible to pay for all services as it is unlikely your supplemental insurance will reimburse for my services in this situation. You and I can discuss how my fees fit into your monthly budget.
Call 847-570-0817 for an initial consultation.
Illinois Licensed Clinical Chicago Psychologist. Counseling is an individual process in which you explore your life and relationships in a different way that thinking on your own or talking with friends or relatives. It is a process focused on your needs, desires, and goals.