Fees & Insurance
All health insurance plans cover mental health services, including individual counseling and psychotherapy for depression, anxiety, PTSD, adjustment problems and other disorders and problems of living. The rates of coverage, limits, and copayments vary by insurance company. A few health insurance plans even cover marital therapy. Dr. Carrin is a preferred provider or on the provider panels for most health insurance plans. In general, the client will be responsible for only the copayment. Formal psychological assessments completed for the courts or for other third parties generally cannot be billed to health insurance. Most other assessments can be billed to your insurance, assuming that they are medically necessary.
If you have questions about your mental health coverage, you can usually get clear answers by calling your insurance company and asking about coverage for "Outpatient Mental Health." You may also call my office for additional information, or for help in sorting out coverage. Once you set your appointment, I will call and verify your coverage before your appointment.
Some medical insurance plans allow you to consult with whatever health care professional you desire. Other medical insurance plans use a managed care company to manage your benefits and require that you utilize a health care professional that is considered a "Provider" in their network.
Due to the continual evolution of managed care, and the incessant merging and re-merging of managed care companies, Provider networks often change. Consequently, I encourage you to contact me and/or your specific insurance carrier to inquire and verify whether I am in your insurance carrier's "Provider Network"
If you intend to utilize your medical insurance to pay for therapy, it will be important that you contact your insurance carrier to make inquiries regarding your insurance benefits. When contacting your insurance company regarding insurance benefits, you must tell them that you are coming to see the doctor for "Outpatient Mental Health Treatment". With some insurance carriers, mental health benefits differ greatly from other medical benefits. The back of your insurance card will give you the correct number to call for information.
With the rapid changes in the health insurance industry and the development of many new health maintenance organizations (HMO's), preferred provider organizations (PPO's), and managed care organizations (MCO's), the rules and regulations regarding health insurance claims have become many and varied.
Please be aware that many HMOs and MCOs require some direct clinical management by their company. Many of the HMOs and MCOs require the release of confidential clinical information to the insurance company in order to process claims and to determine whether additional visits are in their judgment medically necessary. In instances such as this, it may be necessary for us to work together with one of their case managers to determine the nature of your treatment. This obviously will have some impact on therapist/client confidentiality. If you do not wish for any information to be released to your insurance carrier, it is important that you speak to me about this.
Most insurance companies require a co-pay by the patient. This is the amount per visit you are required to pay each time you visit. Some insurance plans also have a deductible, which must be met by the patient before the insurance company will begin to pay benefits. For example, if you have a $200 deductible, the first $200 worth of charges each year will be your responsibility.
Your insurance company may specify a yearly dollar limit that they will pay for psychological visits, or they may limit the number of sessions that you may be seen in one calendar year. If you reach your yearly dollar limit, you will be responsible for the cost of further visits.
Sometimes there are limitations on the types of services covered, e.g. family therapy, psychological testing, or the preparation of a special report may not be covered. In circumstances where you require services that aren't covered, these will be discussed with you ahead of time.
Since each appointment time is reserved for only one person or family, I require that if you must cancel your appointment, at least 24 hours advance notice must be given in order to avoid the full charge. Please note that if you do not keep an appointment without giving at least 24 hours prior notice, your insurance carrier will not pay for my time, and you will be responsible for full payment of the missed appointment.
Because timely payment of all bills is essential to the responsible operation of all professional offices, your payment for services is expected at the time of each visit. If temporary financial problems arise, I encourage you to contact me for assistance in the management of your account. If you have any questions about the above information, please don't hesitate to ask me at any time.