Please take about 3 minutes to fill out the link below (in red). Are we a good fit for you? Please go to this link and answer a few questions that won’t take more than 5 minutes. As you may know, therapist/client rapport is an important element in a successful therapy and as such before we make the first appointment, we ask our clients to do this short screening as we want to make sure we are the best fit helping you and/or your family. As soon as we receive this, we will let you know of the next step. https://www.surveymonkey.com/r/CGZPRNZ

Dr. Michelle Rad, Licensed Clinical Psychologist
EBC, LLC

FAQ

1) What do I ask my insurance when I call them?

Call the behavioral number in the back of your insurance card and ask:
a) How much is my copay for an office visit?
b) Do I have any deductible (individual or family) that I need to meet before the insurance starts paying for  these services?
c) Do I need a referral for therapy/counseling?
  
2) What is a deductible and coinsurance? 
 
When a client is subject to a deductible and coinsurance, that means that they are responsible for the entire cost of the session until their deductible has been met.  For example, in the example below since client X  has a  deductible  that has been met (0 remaining), he now is responsible for a 20% portion of the bill, and their insurance will pay the remaining 80%. Once the OOP (out of pocket) is met, then the client would have no patient responsibility. At that point, the insurance would pay for the entire cost of the service.   Or for patient Y, the patient has no deductible and a copay of 30 dollars which she has to pay at the time of visit.  The rest will be covered by her insurance.   

Patient X: 
Coinsurance 20%
Fam deductible - $3000.00--- Remaining - $0.00
Fam OOP - $6000.00 Remaining --- $2500

Patient Y:
Copay 30
Deductible:  No deductible applies
  
3)  How long/often are the sessions?

Sessions are usually about 40 to 50 minutes face to face and on a weekly basis.  But it depends on the client's needs and fexibility.  The average CBT treatment  is about 6-9 months but many clients want to continue on an as-needed basis to maintain the progress and to prevent relapse.   We recommend you reserving your spot weeks at a time for consistency and making sure that you have a spot every week.

 4)  You reported that during therapy you use psychological assessment and tools to get more data, does insurance cover these?

In some cases, insurance pays for assessments that are related to and useful  for the therapy process and  treatment plan.   Mostly, we use tools that we know are covered by your insurance except if you ask for a specific assessment.   These assessments are effective and provide data that would otherwise take months to gather. They also clearify the diagnosis and help with the treatment plan.
  
 5)  Do es insurance pay for comprehensive psychological assessments and reports?

For a full psychological assessment, insurance pays for a small portion of it but we can get that information before the assessment so you know how much is covered. 

 6) ) How do I check to see if my deductilbe applies for these services?

Plans vary by individual  choice, due to constant changes in insurance plans for behavioral services; it is your responsilbity to know your plan, service, copay and deductible.  For example, some plans are subject to only the family deductible, some to individual deduction, some are PPO, and some others are HMO etc.   Furthermore, some plans may need a referral and some don't  so you will have to check with  your insurance to see  if you  have a balance remaining.  Generally, if you have an HMO, you pick one primary care physician who will coordinate all your health care services. Your doctor keeps track of all your medical records and provides routine care. In order to see a specialist, you’ll need a referral from your primary care physician, except in an emergency. Without a referral, your insurance won’t cover the cost of your care.  But that is not the case with PPO, most PPOs don't need you to have a referal to seek therapy.