It is critical that you understand your insurance plan and the limitations of what they will cover. You have a specific policy with its own nuanced benefit plan which may or may not coincide entirely with our services. No counseling agency can guarantee that your plan will cover services. You will benefit from contacting your insurance proactively to be best informed. It is also important to ask if your therapist is in or out-of-network. You as a client are ultimately responsible for payment.
Private Pay: If you are not using your insurance to pay for your therapy (private pay) you’ll need to inquire about rates with your therapist. In Salt Lake City, standard rates can vary from $85 to $150 per session and above depending on the service and the credentials of the therapist. Some providers offer “sliding scale” services that are set based on your ability to pay. It is important to ask prospective therapists if they offer this option should that be a concern for you.
Superbill: Many therapists provide a “Superbill”, which is a summary of services with applicable billing codes and receipt of payment for the client to submit to their insurance company for personal reimbursement.
In-Network Providers: If your therapist is “in-network” with an insurance, it means they have been accepted credentialed by the insurance company as a preferred provider for that plan. In-network services may come with a copayment which you’ll need to make at the time of each session. Copays can range from $0-$45+ and are based on your plan.
Out-of-Network Providers: Some insurance plans will pay a percentage or reduced amount for services by a provider who is “out-of-network”, meaning they have not been credentialed by the insurance company. Payment is based on several factors, including whether or not you have met your yearly deductible.
Deductibles: Your deductible is the base limit of investment you must make in your medical costs before your insurance will cover services at a higher level (often 80% of total costs of care.) Deductibles can range from as little as $0 to as much as several thousand dollars per year. Sometimes you can pay for your therapy upfront and receive a statement which you can submit to your insurance for partial reimbursement.
HSA: Some plans include Health Savings Accounts (HSA’s) that can be used to pay for all healthcare services regardless of in-network or out-of-network qualifiers.
It is critical that you understand your insurance plan and the limitations of what they will cover. Ultimately, no provider can guarantee that your plan will cover services, and you’ll benefit from contacting your insurance proactively to be best informed. It is also important to ask if your therapist is in or out-of-network.
For billing and insurance questions email Kathryn!
Questions about payment options? Having difficulty with your insurance?
We have a specialist who can help.