Payment Information

Payment Information

I am an out-of-network provider. Payment is due following the session.  A credit/debit card is required to be kept on file via my HIPAA compliant, secure system
I supply a “Superbill” which will have the required information to submit the invoice to your insurance company for reimbursement.
If you are attempting to utilize your insurance benefits, I recommend you call your carrier directly to clarify the benefits prior to meeting with me.  The following questions may be helpful to ask:
  • How much are my “out-of-network” benefits for psychotherapy provided by a psychologist? (The CPT code for a typical 50-minute individual session is 90834. The code for a typical 60-minute couples/family session is 90847.)
  • Is there an out-of-network deductible? If so, has it been met?
  • Where can I find an out-of-network claims form? Where/how do I send in the claim after I complete it?
  • Is there a difference in reimbursement rates for telehealth vs. in person services?
  • Is there a limit to the number of sessions for I can be reimbursed for, and/or do I need to obtain an authorization prior to seeking treatment?
  • What documentation do I need to submit to receive reimbursement? Where/how do I submit these? Is there anything specific that I need to ensure is included on the Superbills I receive (e.g., do they have to be signed by the provider and/or myself)?

Cancellation Policy

Clients are free to cancel or change a scheduled appointment provided a 48-hour notice has been given. I prioritize my clients by holding space for each person I see. When clients cancel an appointment, I offer that space to other clients who need an appointment that week. When clients cancel within 48-hours or no-show, other clients miss out on an opportunity to be seen. 
If you would like to cancel an appointment, I ask that you do so with at least 48-hours notice. Anyone cancelling an appointment with less than a 48-hour notice will be charged their full session fee. The cost of missed sessions is not typically covered by your insurance company. I will charge the credit card on file for late cancellations and no shows.

Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost. Under the law (“No Surprises Act”), health care providers need to give patients who do NOT have insurance or who are not using insurance an estimate of the bill for medical services when the estimate is requested. Additional details:
  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical services 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.
  • Make sure to save a copy or picture of your Good Faith Estimate.
  • For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 800-985-3059.