RATES AND INSURANCE
Preauthorization and Mental Health Benefits
This will be determined by your specific insurance plan. It is likely that if you are in network with one of our providers, you will either be responsible for a copay, possibly working towards fulfilling your annual deductible, or you may have mental health benefits that are considered out of network. Prior to scheduling, you are advised to contact your insurance carrier to see if you are in network with your therapist. Here are some helpful questions to ask to see if your plan has in-network benefits:
Does my plan cover mental health benefits? (Ask about in-office counseling as well as telehealth counseling.)
Is pre-authorization required for in-office counseling?
What is my responsibility per session? (Does it go towards my deductible or do I owe a copay?)
What is my deductible and out-of-pocket maximum?
After my deductible and/or out-of-pocket is met, what do I owe?
Is there a maximum number allowed for visits per year? What happens if I go over that allotted amount?
When does my plan renew (calendar year vs contract year)?
Are there any exclusions on my plan (some plans do not cover marriage therapy, family therapy, or therapies pertaining to Autism Spectrum, ABA therapy, etc.)?
What percentage of the cost will be covered if I see an out-of-network provider?
Your insurance company may provide a level of reimbursement for out-of-network charges. If that is the case, we will provide you a superbill that you may submit for reimbursement. We will also verify your benefits prior to your first session. Please have your insurance information available when you are calling to make an appointment if you desire to use it. It is your responsibility to keep your clinician informed of any changes to your insurance plan. The Wellness Counseling Group and its members will not reimburse or backtrack claims through insurance due to negligence of updating insurance information in a timely manner. All denied claims from your insurance company will be your responsibility.
Other Important Insurance Information
Insurance will not pay for missed or late-cancel sessions. In these cases, you will be responsible for the full-session fee. A minimum of 24-hour’s notice of cancellation is required. If your insurance company requests a report to process your claim, you are responsible for payment for the report writing service. We will notify you of this requirement in advance of writing and billing for the report.
Payment is due at the time of your appointment. You will be greeted by one of our administrative staff upon coming into the office. She will handle the check-in process for you, including taking payment before you see your therapist. Arrive a few minutes early in order to check in successfully without taking time out of your appointment window. The Wellness Counseling Group accepts payment in the form of cash, checks, major credit cards, as well as FSA/HSA cards. A $35 charge will be due for all returned checks.
$130-$150 depending on the clinician, per 53-minute appointment.
Good Faith Estimates
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 to discuss at 800-985-3059.