At Audere Counseling, I offer a free 15 minute consultation to see if we may be a right fit. Call 508-521-9899, let's talk!

I am currently working on credentialing with health insurance companies, which will allow me to accept insurance - but it takes time.

In the meantime, I offer self-pay and Out of Network (OON) options:

Self-pay: 55 minute session - $150.

Sliding scale is available, based on circumstances.

Debit, credit, HSA and FSA cards are accepted through Ivy Pay - secure online system designed for therapy services.

Out of Network: Check with your insurance company to determine if they offer out of network benefits and how to best use them.

OON means I do not have an agreement with your health insurance, and I set my professional fees. Some insurance companies allow the use of OON providers, and it is beneficial if you speak directly to your insurance company to find out, what copays may apply, and what limitations may be assigned (can you use Telehealth? Is there a limit for the amount of sessions? Do you need prior authorization for services? Etc.)

I provide Superbill that can be submitted to your insurance company for reimbursement of all or portion of your bill. I encourage you to check out Thrizer (non-affiliated service that helps with Superbills for a small fee).

Benefits of Private Pay: when therapists bill insurance companies, they need to come up with a diagnosis to justify "medical necessity" for services. Not all life situations require or qualify for a diagnosis. Not all life situations benefit from a mental health diagnosis. Private Pay allows you to take full control of your therapeutic journey.

GOOD FAITH ESTIMATE

Under the No Surprises Act (H.R. 133 - which went into effect on January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

• This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.

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

• The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.

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

  • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.

  • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.

  • There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.

• Make sure your health care provider gives you a Good Faith Estimate within the following timeframes:

  • If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;

  • If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of scheduling; or

  • If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided, within the specified timeframes if the patient reschedules the requested item or service.

• Make sure to save a copy or picture of your Good Faith Estimate.

• This is the public disclosure of the “Good Faith Estimate”

Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment.

To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.

If you have questions or concerns, please reach out.