Billing Options and Practices
Counseling Professionals PLLC understands that therapy has financial considerations and should be a collaborative process. Our goal with this page is to empower clients to better understand the billing process and issues that may occur along the way to hopefully prevent those issues and help build trust as our goal is to focus on your treatment goals.
Reimbursify Insurance Check
If you use the third party insurance check, it may take a minute or two to process and then we will automatically forward the information to you. Remember that this is not a promise of coverage from Counseling Professionals PLLC. We do not take Medicare, Local or Value versions of different plans, or specialty plans, but we can request single use exceptions. The coverage information you receive is what the insurance company replied with to our inquiry, not a promise of coverage. We only truly know the coverage after we submit a claim. We offer accommodations if your coverage is not good or if we cannot take your insurance for any reason. We encourage that you get in touch with your insurance company and get coverage details directly before starting counseling. The codes we use are 90791 for Intake and 90837 for 1 hour sessions. We will be in touch with you shortly to provide what information we received. Thank you for checking and we hope to work together soon!
We encourage you to also learn about how insurance works and the process we go through with billing below.
If you would like to use them for submitted out of nework claims, you can see a video on how to do that here:
Special Note: Counseling Professionals PLLC has 17 different billing accommodations to help keep counseling accessible and flexible with your situation to make sure you have continuity of care. If you need any flexibility, please talk to your provider. We also have interns who provide discounted, free, or paid counseling in some circumstances, which is linked Here.
Billing "Road" Process
Billing takes time and many points to process medical payments and work with insurance, the image to the left is the general overview of what that looks like to successfully process a claim.
Avoid Billing Delays & Issues with Support
Upload insurance information as soon as you have access to Therapy Notes
What is not Covered by Insurance
No-Show and late cancelations are not covered by insurance
Consistency helps therapy outcomes
No shows are not always charged, but regular no-shows may result in termination or transfer of care as it undermines treatment outcomes and therapist scheduling and income.
This policy helps honor the provider’s time and allows other clients access to services
Common Insurance Terms
Deductible: Before your insurance starts paying for your visits, you need to pay a certain amount of money for healthcare.
Co-Pay: Each time you visit the doctor or get a medicine, you pay a small part of the cost, even after you meet your deductible.
Co-Insurance: You and your insurance company share the cost of your doctor's visits or medicine. If your co-insurance is like splitting a pizza, you might pay for 2 slices (20%) and your insurance pays for 8 slices (80%). This may kick in after you meet your deductible.
Out of Pocket Max: This is the most money you have to spend on your own in a year for doctor's visits and medicine. Once you've spent this much, your insurance company pays for everything else.
In-Network: These are doctors and hospitals that your insurance company likes to work with and will pay more of the cost for you to see them.
Out of Network: These are doctors and hospitals that don't have a special deal with your insurance company. If you see them, you might have to pay more money.
Renewal Date: Every year, your plan starts over, and you might get a new card or new details about your plan which we need and your deductible comes back and starts over.
Health Claim: When you go to the doctor or get medicine, the doctor sends a note to your insurance company asking them to pay for it. This note is called a "health claim."
HSA (Health Savings Account): This is a special savings account for doctor's visits and medicine. Money you put in here doesn't get taxed, and you can use it to pay for medical stuff.
Flex Spending Account (FSA): This is another type of special savings account for your health. You can put money in it from your paycheck before taxes are taken out, and use it for doctor's visits, medicine, and other health stuff.
Timely Filing: Doctors and hospitals have to send the health claim to the insurance company quickly, or the insurance company might not pay.
Clearinghouse: Think of this as a post office for health claims. The clearinghouse gets the claim from your doctor, checks it to make sure everything is correct, and then sends it to the insurance company.
Third Party Carve Out: This is when your insurance plan has a special part just for certain things, like dental visits or eye glasses. This is important to know as Mental Health Coverage is sometimes covered by a completely different health insurance to your main healthcare.