Paying for Services and Billing Insurance

Things People Most Want to Know

We are an out of network provider or private pay counseling practice so fees are paid in full at the time of service. Payment can be made in the form of cash, check, or credit card.

As a healthcare provider, we accept Health Savings Account (HSA) and Flexible Spending Account (FSA). This coverage usually can go towards your deductible!
Depending on the clinician, our fee schedule is as follows:

  • Intake Assessment – $250
  • Counseling Appointment – $170 – $185

One of the core values of Power Within Counseling is freedom. We want you to have the freedom to choose to bill insurance or choose to pay out of pocket. We also take our client’s confidentiality seriously, and we protect your information. We also do not want you to fear what will be done with the information you share and how that may affect you or your child’s future.

If we take insurance we are required to use an Electronic Medical Records system where that information is disclosed to a 3rd party insurance or technology company, which adds a greater risk with your information being out there and stored. Through a variety of background checks or career choices, a diagnosis may be disclosed by your insurance carrier. We want you to feel secure and free to open up in your therapy sessions with the trust that what you disclose will stay between you and your therapist.
In order to receive reimbursement from insurance companies, a therapist must give you a diagnosis. Sometimes there is not an appropriate option, and insurance companies still require a diagnosis. We believe everyone should have access to counseling without a diagnosis, and we want you to be able to get the help you need to reach your goals without having a label.

By not contracting with insurance companies we don’t have to follow their unnecessary rules or mazes they have created. We are also no longer forced to follow their uninformed recommendations since they are no longer financing the services. Our time is devoted to researching the best treatment, and planning the appropriate interventions for your care ensuring the best possible service for your situation.

Insurance companies decide treatment schedules by determining the number of sessions and the frequency (i.e. weekly, monthly, biweekly) they also get to decide who, where, and how long you get to see a therapist for. We believe in your freedom and that this should be you and your therapist’s choice.

When an insurance company is involved, they can determine what they are willing to pay for or what specific treatment you need without ever having met you or your child. Freedom in mental health treatment will not be compromised. We believe in self determination and our clients choose what is best for their mental health with their trusted therapist.

At Power Within Counseling, you and your counselor are in charge of your treatment; not what someone sitting in an office in another state feels like you should need based on math and not having even met you. Without insurance involvement,  We are able to adapt to your treatment needs quickly if something needs to change given a life event or circumstance, we can do that freely! Power Within Counseling’s core value is Sacred vow, which means that we ensure you get the best quality of counseling treatment possible.  To see if your insurance company reimburses you for out of network coverage, please use Mentaya below.

To verify your potential coverage for out of network benefits, please call your insurance carrier on the back of your card before you begin counseling.

Depending on your current health insurance provider, it is possible for services to be covered in fully or partially and many of our clients have used their out of network benefits coverage.

Please contact your insurance provider directly to verify how your plan reimburses and how much you out of your insurance covers for Out of Network psychotherapy services. 

We always recommend calling before your first appointment so that the insurance reimbursement is clear and there are no unexpected billing surprises for you!

If you plan to try to get reimbursed in the future, we still recommend that you call your insurance company before the first appointment.

Here are some good questions to ask below.

  • Do I have a deductible? If so, how much is it?
  • Does my health insurance plan include out-of-network mental health benefits?
  • Do I need preauthorization to be reimbursed for out-of-network mental health services?  If so, what is the process for obtaining preauthorization?
  • What percentage or amount of my sessions will be covered after I’ve met the deductible?
  • Are specific diagnoses required for me to get reimbursement?
  • Does my plan limit how many sessions per calendar year I can have? If so, what is the limit of sessions per year?
  • Do I need written approval from my primary care physician in order for services to be covered?
  • What credentials does a provider need to have in order to be reimbursed or is it possible to be reimbursed for a provisionally licensed therapist or counselor-in-training who is properly supervised? (Some of our providers have a provisional license CSW, LSW, ACMHC )
  • What percentage of my out-of-network mental health services will be covered if I submit a Superbill with the diagnosis and CPT codes? Is there anything else I will need to submit with the Superbill to obtain coverage?
  • How do I get reimbursed for out-of-network mental health services? 
  • What is the process for submitting a Superbill? How frequent do I submit the superbills, and how long will it take for me to be reimbursed?

 

***After gathering this information, we recommend you ask for a  call confirmation number and the name of the representative giving you this information with your insurance company and keep it in your records.***