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Insurance and Rates

Benefits of Not Using Insurance
 

  • Choosing a therapist that’s right for you – Participating insurance panel therapists apply to participate on that insurance panel, and are accepted per the insurance company’s availability to add new providers to their panel. Insurance companies typically include therapists based on location, price, or therapeutic approach. This may mean that access to customized, quality mental health care is limited and you may find your therapist is not a good fit for you.

  • Control over your therapy – Many insurance companies set limits on the type of treatment, appointment frequency, or amount of sessions you may have. Insurance companies may demand a review of your mental health records, which means they can review and/or question the treatment you are receiving and/or whether or not they will decide to continue or discontinue coverage for your sessions. Insurance companies may also require that you take medication before they will approve counseling sessions for you.

  • Confidentiality – Insurance companies require, at minimum, client name, dates of service, and mental health diagnosis in order to pay (or reimburse you) for your therapy sessions. While your counseling is confidential, you must sign a form that allows the counselor to communicate this confidential information to your insurance company. In the event that your insurance company requires pre-authorization for treatment and/or reviews your file, additional information, such as therapy session notes, must be provided to the insurance company. It is important to note that this information becomes part of your record and could be used by insurance companies to determine future insurance rates or eligibility, eligibility in the armed forces, driving record, etc. This is particularly important when considering counseling for your child(ren).

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Good Faith Estimate

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 800-985-3059.

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