PAYMENT AND INSURANCE
My fees are $200 for 45-min. individual sessions, and $250 for 60-min. couples sessions. In a limited number of cases, I may offer a “sliding scale,” though such an arrangement would be agreed upon following an assessment about an individual’s financial need and available resources.
Payment can be made by cash, check, or online with credit/debit cards through the use of Venmo or PayPal. My username with Venmo is @Kaerensa-Craft (www.venmo.com/Kaerensa-Craft), and my username with Paypal is firstname.lastname@example.org. (Please note: Clients opting to use credit or debit cards are responsible for paying the 2.7% fee of the transaction amount charged by PayPal. Venmo offers a free option for submitting payment if the payment is withdrawn directly from a bank account.)
Upon agreeing to meet at a regular day and time each week, I ask patients to maintain financial responsibility for the session times, whether attended or not. This includes for planned absences discussed in advance, as well as unforeseen absences (e.g., illness).
If you know in advance that you won’t be able to attend, and would like to try to reschedule the time, I will be happy to offer you whatever other times I may have available. However, I can’t guarantee that I will have another time available, or that I will have a time that works for your schedule. (I can offer phone sessions and/or online video sessions, either at the time of your session or for a rescheduled time, if you cannot attend in person.)
For patients utilizing insurance to help pay for treatment, please be advised that I am not allowed to bill insurance companies for missed or canceled sessions. If you are unable to attend a session and we cannot find an alternative time, you will be responsible for the full cost of the session.
I currently accept Medicare, Oxford, United HealthCare, United Behavioral Health, Optum, OSCAR, and SEIU1199.
For all other insurance plans, I am an “out-of-network” provider, which means that your insurance plan needs to include out-of-network mental health benefits
(also referred to as “behavioral health” benefits) to be applied to my services. (Please note that some plans require initial authorization for treatment from your insurance company. You may also be required to obtain periodic re-authorization. You should ask about this when you call to check your benefits, and to ask for initial authorization if that's required.)
- Do I have out-of-network benefits?
- What is the cost of my deductible before my plan starts paying on out-of-network services?
- Is my deductible for mental health/behavioral health separate from my deductible for physical health, or is the deductible combined?
- Do I have an in-network deductible as well, and if so, does that count toward my out-of-network deductible?
- How much of my deductible has already been met?
- What is my out-of-pocket maximum, and does my deductible count toward the out-of-pocket maximum?
- Does my plan reimburse a flat rate for out-of-network services, or is it a percentage of the provider’s fees? (If a flat rate, what is the amount? If a percentage, what is the percentage?)
- If my plan reimburses at the "Usual-and-Customary" rate, up to what amount is allowed (The insurance representative may ask for the following in order to tell you if your plan covers it: The procedure code, also known as the CPT code, is 90834 for individual therapy, and 90847 for family therapy. The provider's fee: $200. The provider's licensure: LCSW. The provider's National Provider ID (NPI): 172-010-3807. The Place of Service code: 11. The zip code: 10010.)
- Does my plan require pre-authorization? (If yes, you should request authorization at this time. If needed, my National Provider ID (NPI) number is 172-010-3807. The procedure or CPT code for a 45-minute individual psychotherapy session is 90834.)
- Does my plan require periodic re-authorization? (If yes, you should ask how many visits the initial authorization covers so that you will know when to request re-authorization for additional visits.)
- Where do I need to send claims for reimbursement?