FEES & INSURANCE

RATES:

Please call me at (917) 204-7259 or send an email to rebecca@rebeccamross.com to discuss rates for service. Fees can vary depending on the length of the session and the number of participants in the therapy.

For those experiencing financial hardship, a sliding scale is available.

Phone or Skype sessions are available to existing clients and fees are negotiated based on the length of the call.

A fee will be applied for any cancellations that occur in less then 24 hours from the scheduled session.

INSURANCE:

I can provide monthly invoices for you to submit to your insurance companies for “out-of-network” reimbursement.

To find out if your insurance accepts out-of-network provider coverage, here are some suggested questions to ask when you call your insurance carrier:

TIPS for filing your FIRST CLAIM with an insurance company with whom you have never worked before. This will speed up the process of getting yourself ‘registered’ as a provider.  After you have been paid or your client has been paid by the carrier, you will not need to send all this data again.

  • Send the first claim in yourself (rather than client).
  • Complete the 1500 claim form as demonstrated in workshop.
  • Submit a W-9 form (with your social security #, or if you got a TIN/EIN use that).
  • Submit a copy of your license.
  • Submit a copy of your malpractice insurance.
  • Submit a copy of your invoice

Information you will need when calling the insurance company about a patient:

  • Fulll name of client
  • Insurance ID#
  • DOB (Date of Birth)
  • Address on file with insurance company
  • Dates of service (to check eligibility)
  • Your own SS# or NPI

You can confirm that the client has insurance, what the benefits are, what the deductible is, and whether there are any limits on behavioral health (such as biologically-based vs non-bio based visit limits). You probably cannot find out what the exact reimbursement is, but you can find out what percentage of “usual and customary fee.”

HOMEWORK:  Call your own insurance company, first as a customer. See if you can get the answers to all these questions. Then, call as a provider. You can also ask if they have any limits on the licenses they cover.

IMPORTANT NOTE about GHI. So far, GHI is the only provider we’ve encountered who pays ONLY LCSW-R for out-of-network benefits. This is confusing, because most payors will cover all the licenses. GHI is very restrictive and sometimes the people on the phone do not give this information. We learned this the VERY hard way and ended up seeing two GHI out of network clients for several months without payment. It is possible that other carriers will become more restrictive in coming months, so it is always good to check and see what their current reimbursement policy is.