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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
judgement
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.
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