Fees
My practice is entirely private pay with the exception of Medicare assignment. I am able to see current Blue Cross until February 28, 2012, but I am no longer participating in any insurance networks.
I’ve slightly lowered my self-pay fees in order to make my services relatively more affordable. The fee for an initial one hour consultation is now $175. Fees for subsequent 45-50 minute therapy sessions will be $150. Fees for psycho-educational testing for learning disabilities, gifted, or accommodations in school or SAT/ACTs, autism spectrum disorder, and AD(H)D are not insurance reimbursable are listed in the Evaluations page. Fees are due at the time of service paid by cash, check, Visa or Mastercard.
Missed Appointments
Patients may be charged a fee for appointments not cancelled within 24 hours of the appointment time. Exceptions are made for emergencies or events out of a patient’s control.
Using your out-of-network benefits
You’ll be required to pay my fee when services are rendered, but you may be eligible for partial insurance reimbursement if you have out-of-network mental health benefits. Almost all BC/BS PPO and Blue Options plans have these benefits. (Educational evaluations are not covered by any insurance company). I’ll provide all the paperwork you need to file these claims. To determine your benefits, call your insurance company and ask the following questions:
1. Do I have out-of-network outpatient mental health benefits?
2. What is the out-of-network deductible I must satisfy prior to receiving reimbursement?
3. What is the percentage of the doctor’s fee that will be reimbursed? Understand that your reimbursement will not likely be based on my fee, but rather on a fee established by the insurance company called “usually, customary & reasonable” (UCR). This fee is established by insurance companies and approximates the Medicare fee schedule.
An example: Blue Cross tells you that you have a $500 out-of-network deductible and they reimburse 60% of the UCR fee. This means you have to pay some out-of-network doctor(s) $500 first before insurance reimbursement kicks in. Then, insurance will reimburse 60% of the UCR fee for the service I provide. Insurance companies have UCRs for different services listed by procedure codes. The most common procedue codes you’ll want to inquire about are 90801, 90806, 90847. You’ll then be able to estimate the difference between what you’ll pay me and what you’ll get reimbursed.
Click this link to obtain instructions and the form you need to submit with my superbills for reimbursement from a Florida Blue Cross. If you have a BC plan written from another state, call the 800 number on your plan to get the appropriate form. If you’re a BC Florida State Employee, use this form and if you’re a BC Federal Employee, use this form.
