Costs & Fees
How does insurance work with psychotherapy?
Managed care has created major changes in how psychotherapy treatment is provided. I will explain different payment options and how each works.
Fee-for-service (when you pay for psychotherapy on your own with no insurance coverage) gives you the most freedom. You are free to consult any psychologist and get treatment based on what is best for you. The privacy and confidentiality of your treatment is best protected in this scenario. You should discuss fees when you call for your appointment. Fees are determined by your insurance coverage and your individual circumstances.
The next best option is traditional (or indemnity) insurance. Under traditional insurance plans you are free to consult any licensed psychologist you choose, and you decide on a course of treatment formulated by you and your therapist, just as when you pay for treatment on your own. The privacy and confidentiality of your treatment is changed minimally; however the therapist must provide your diagnosis and dates of service o the insurance company in order to have the visits covered by insurance. Most indemnity plans require some co-payment.
Currently, many insurance plans use managed care organizations to control the cost of medical and mental health treatment. Florida, in particular, is heavily controlled by “managed care.” This creates a radical change in treatment planning and privacy issues.
The differences are:
With managed care, you must call to request authorization to see a therapist. If your plan is an HMO, your treatment options are the most limited. You are required to see a provider on their particular panel. Sessions are parceled out in small numbers (for example, BCBS Health Options gives 3 sessions initially then the therapist must fill out paperwork to “request” more.) Treatment planning is conducted by a managed care “case manager” with cost containment in mind. The “case manager”, who has never seen you, and may have no mental health training, will decide whether treatment is authorized. The voluminous paperwork and low fees are a deterrent for successful therapists to participate on these panels. Other deterrents for therapists include pressure from the managed care company to restrict the number of visits provided, and a limited number of TOTAL annual sessions (commonly, 20 per year are allowed). That means that the managed care company will dictate your treatment, WHICH MAY NOT BE by the best standards of practice.
In summary, the advantages of seeing a provider within your managed care network have hidden costs in terms of the experience and quality of your therapist, and his or her autonomy in providing the best treatment for your problems.
In our office we provide assistance with Billing from our professional Medical Biller. We are equipped to handle all questions and will conduct the research, follow up and all necessary paper work to allow you to understand and obtain benefits from your insurance provider.
Fees for Testing/ Assessment?
Dr. Cohen’s fees for assessment include the initial parent/client interview, the direct contact hours spent administering the psychological tests, a feedback meeting, and a comprehensive written report with practical and specific recommendations. If you are unsure about whether or not you or your child needs an evaluation, Dr. Cohen will be happy to provide you with a complimentary phone consultation.
TERMS OF PAYMENT FOR TESTING /ASSESSMENT
Dr. Cohen typically asks that half of the fee be paid on the first day of testing and that the balance be paid upon receipt of the written report at the feedback session. For families experiencing financial hardship, options for convenient payment plans can be discussed. Dr. Cohen’s office will provide assistance with Billing Services and will work to collaborate with insurance companies and families whenever possible.