Insurance

Currently, I participate with the following insurances:

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• Aetna

• Anthem EAP

• BCBS

• Cigna

• ComPsych EAP

• Harvard Pilgrim

• Health Advocates EAP

• Optum (including United Healthcare, Allways, and United Behavioral Health)

• Tufts/Point32

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I am an out-of-network (OON) provider with most insurance companies and am happy to provide you with a superbill to submit to your insurance for reimbursement if you have OON benefits. Please contact the customer service number on the back of your insurance card to determine if your plan covers OON benefits

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Private Pay

I accept private pay/out of pocket payment for individuals who do not wish to use their insurance. There are a variety of reasons why people choose to not use insurance benefits for therapy. For example, you may find that you connect well with a provider who does not accept your insurance plan, or you may find a provider who does not take your insurance but  has a certain skill set that may be helpful to you. Additionally, insurances require a diagnosis that meets certain criteria in order to cover services. Not all people seeking therapy meet this criteria. Also, some individuals do not wish to have this identified as part of their medical record (for example in instances of divorce and custody hearings or high profile jobs). 

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Sliding Scale

I offer limited sliding scale slots. Please connect with me if you are interested in discussing sliding scale options. 

  

Late Cancellations

For current clients I require 48-hour notice for cancellations. Late cancellation/no show fees ($75) will apply if less notice is given, and will be charged to you automatically. 

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Payments (via electronic payment  method) are expected at the time of your appointment. 

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No Surprises Act

Your Rights and Protections Against Surprise Medical Bills

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

 

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care - like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

• Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

• Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

• Your health plan generally must:

  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).

  • Cover emergency services by out-of-network providers.

  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: www.cms.gov/nosurprises/consumers

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.