Insurance and Fees

Insurance

I am an out-of network teletherapy provider, and you must be asking yourself, I have insurance why would I choose an out of network provider? Here are some reasons going out of network can be beneficial:

  • I have the ability to spend more time focusing on you. When a therapist takes insurance they are spending hours every week submitting claims or on hold with an insurance representative. This takes time away from reviewing your session notes, advocating for you, and taking the time to improve upon my skills so that I can best support you. 

  • Insurance companies require in-network therapists to submit detailed information regarding services provided including the reason the session occurred and how long the sessions were which really get in the way of your privacy. 

  • Insurance companies also require in-network providers to provide a diagnosis. Oftentimes clients come in seeking support around general mental health issues such as stress, relationship issues, and life transitions which do not require a diagnosis. However, they are often having to give a diagnosis of adjustment disorder or anxiety disorder in order to get reimbursed. 

  •  Insurance companies may put restrictions on the number of sessions or limit sessions to 45 minutes. If a client would like an intensive session in order to achieve treatment outcomes faster the insurance company would limit that. 

  • Finally, Being out of network allows me to specialize in my areas of interest. 

If you are interested in using your out-of-network benefits click here for questions to ask your insurance company.

Fees

Initial session 60 minutes $200.00

Individual session 45 minutes $150.00 

EMDR 90 minute processing $250.00

To make this easier and more affordable for my clients, I have partnered with Advekit. Advekit will check your out-of-network benefits, and they will handle the out of network billing for you. You only pay what you owe. 

Example: If a session costs 150.00 and your out of network benefit is 30%, you only pay $45.00 for our session Advekit will handle collecting the 70%. This allows for therapy to be more affordable. Click the link below to get started.

 

https://www.advekit.com/therapists/ana-pais

Cancellation Policy:

If you do not show up for your scheduled therapy appointment, and you have not notified me at least 24 hours in advance, you will be required to pay the full session fee that is not refundable by your insurance company.

GOOD FAITH ESTIMATE Information:

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

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