Heidi Halsey, MA, LMFT
Heidi Halsey, MA, LMFT
2832 S. Meridian Street
Suite 204
Puyallup, WA 98373-1447
United States
ph: 253-446-9222
fax: 253-770-7787
heidital
Do I accept insurance? What are the fees for counseling?
As far as fees, insurance makes a big difference. Here is the general information. It is detailed because I get so many questions and this usually answers them.
The amount I charge is almost irrelevant if a person is covered by insurance. The amount the client pays is based upon what amount the insurance company allows. If the client has a 'cost-share' insurance plan where they are responsible for a percentage of the charges, the percentage they pay is their percentage on the amount allowed by the insurance company, not the amount I charge.
If the client's insurance has a set copay, then that is the amount the client is charged.
If a client has a deductible, they are expected to pay for their sessions at the time of the appointment until their deductible is met. We will charge the amount that the insurance company usually allows us to charge unless a client contacts the insurance company to find out exactly how much their insurance company allows for assessment, individual or family sessions.
Co-pays, cost-share and deductibles are due at the appointment.
A client's insurance will will cover me if I am on the insurance company list or if they have 'out-of-network benefits' as part of their insurance plan or if their insurance company doesn't require providers to be on a list. I am on most plans but you should check your own benefits. The benefit number is sometimes listed on an insurance card as benefits, customer service or on the health insurance card following MH/SA (mental health/substance abuse).
Clients should look on their insurance company website or call their insurance company and ask if I am a covered provider if they have a plan requiring providers to be contracted with the insurance company. If I am not a preferred provider they should ask if their insurance provides 'out of network benefits'. If their plan covers 'out of network benefits' ask if they will cover a Licensed Marriage and Family Therapist. Clients should call or make sure they have a referral or authorization if needed as we do not do that. If you don't check your benefits and don't know what your coverage is, we will guestimate what your portion will be from our experience with your insurance company. If you check your benefits, we will use your information.
Insurances that cover counseling cover individual counseling. If a person is having anxiety and/or depression or other symptoms whether or not the cause is from a relationship, the insurance company will cover the counseling when we are addressing the anxiety and depression or other symptoms that will improve while also addressing how these or other symptoms are caused by or how they impact a client's relationships. If an insurance company covers family sessions we may bill for family sessions if more than one person is attending and we are addressing things that involve the family members. It is helpful to know if your insurance covers family counseling. Most couple counseling includes addressing a symptom that is medically covered by the insurance company. These medically identified symptoms and behaviors can be addressed on their own and when they are involved with a client's relationships. Medically covered symptoms can include and are not limited to: anxiety, depression, exhaustion, lack of motivation or focus, explosiveness, obsessions, compulsions, racing thoughts, mood swings, fearfulness, worry, nervousness, panic and substance abuse.
If a person is covered by two insurance plans, they MUST use their primary insurance before the secondary insurance can be billed for the amount remaining after the primary insurance company pays. If we receive inaccurate insurance information from a client and cannot correctly bill the current insurance company and thus the charges are denied, we will be billing the client directly and payment will be need to be paid immediately.
If two people are coming in together and they have different benefits, they will want to check and compare benefits to see whose coverage is best for counseling.
If people don't have any insurance coverage then the charges are $125 for the first session, $100 for couple or family sessions and $90 for subsequent individual sessions. If I am a provider for someone's insurance and we have that insurance information from the client, I have to bill the insurance per my contract with the insurance company and have to go by what they allow charged.
I cannot write off any portion of what the insurance company says the client must pay.
The insurance company will NEVER pay for a no-show or late cancellation or telephone appointment or emails or phone calls or letters. These will have to be paid by the client at the next appointment or upon receipt of the bill - whichever occurs first.
- EMPLOYEE ASSISTANCE PROGRAMS:
- Many employers have EAP / Employee Assistance Program benefits that provide a number of sessions with a contracted therapist before a client uses their health insurance so the sessions are free to the client and thus without a copay or deductible. These benefits are often available to all employees whether or not they are covered by the health insurance through the employer and whether or not the employee is full or part time. These EAP benefits are often available to all family members and sometimes to all people living in the employee's home whether or not they are family members. I contract with several EAP companies so it is important to clarify what company your EAP utilizes so that we bill the correct company. A REFERRAL OR AUTHORIZATION IS ALWAYS NECESSARY FOR AN EAP BENEFIT. YOU CAN GET THIS AUTHORIZATION THROUGH YOUR HUMAN RESOURCES DEPARTMENT OR THROUGH A PHONE NUMBER ON YOUR BENEFIT'S CARD. This number is sometimes on the benefit card following MH/SA (mental health/substance abuse).
For other services including court ordered coparent counseling, mediation and expert witness work for custody disputes or other situations, please contact my office.
Still have questions?
Please contact us anytime! We look forward to hearing from you.
Copyright Heidi Halsey, MA, LMFT, Inc., 2007 All rights reserved.
Heidi Halsey, MA, LMFT
2832 S. Meridian Street
Suite 204
Puyallup, WA 98373-1447
United States
ph: 253-446-9222
fax: 253-770-7787
heidital
