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Tree Roots

Fees and Good Faith Estimate Statement

INSURANCE/FINANCIAL POLICIES:

The practice currently participates with Anthem BC/BS, Aetna, Cigna, and Optum (United HealthCare and/or Oxford and Connecticare).
For other insurance plans, we can provide you with a receipt for payment that you may use to file a claim for out-of-network benefits. 
Please note that if you waive your insurance (and self-pay), you cannot file for out-of-network benefits, and any payments you make will not go towards satisfying a deductible. We do not file claims for out-of-network plans or accept payment from insurers that we are out-of-network with.
Co-payments, deductibles, and ALL session fees are due at the time of service. Bills/invoices for services are not routinely sent. It is your responsibility to know what your specific insurance plan covers and what your responsibility is as the subscriber. Many of the newer plans now have large deductibles/co-insurance. Some self-funded (employer-driven plans) can opt out of telehealth coverages and/or have mental health benefits managed by a third-party administrator (TPA) or another specialized provider list. We are not considered Teledoc, MDLive, Sesame Care, or PlushCare providers or part of any other special telehealth network. Some insurers may also require authorization for certain service codes. Additionally, if you have more than one insurance policy, you must provide the information for both, including which plan is primary. It is your responsibility to coordinate these benefits, and you are responsible for any denials we receive. Please review your benefits carefully.
Although we make every effort to get claims processed successfully, you are responsible for any and all denials from your insurer, regardless of the reason for the denial.

SELF-PAY RATES:

We believe in transparency when it comes to our self pay fees. Those clients who are uninsured, have an insurance we do not participate with (we are considered out-of-network as a group or per provider) or elect not to use their insurance even if we are in-network are considered to be self pay clients.
Please see our full fee rates below effective January 1, 2023. If you are unable to afford the current fee, please contact us to discuss possible options.
Fully Licensed Staff:
New or Returning Client Intake Assessment: $225
60 minutes Individual Therapy Session: $180
45 minutes Individual Therapy Session: $145
Family Session: $200
Brief 20-30 min Individual Therapy Session: $105

Good Faith Estimate of Expected Charges

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

  • If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • If you receive a GFE from us please make sure to save a copy or take a picture of it. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises

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