Insurance, Fees & Policies

The Virtual Couch believes that Humans should not be pathologized in order to receive care so I do not accept Insurance.

I will no longer be in-network with Blue Cross and Blue Shield effective June 30th, 2024.

Private Pay Rates using an Equitable Pricing Model

At The Virtual Couch we believe that everyone deserves access to quality mental health care, regardless of their financial circumstances. That's why we've adopted an equitable pricing model designed to make therapy more accessible and affordable for all individuals. To determine what rate fits your needs consider using the Green Bottle Model by Alexi Cunningfolk (Click Here).

Consultation

Free

20 Minutes

I offer a free initial consultation. During our consultation I will take the time to get to to learn more about you. Some questions I may ask:

  • Why are you seeking therapy?

  • What are your counseling goals?

  • What are you seeking from a therapist?

  • Any previous counseling experiences?

You will also be encouraged to ask any questions, comments, or concerns.

Intake Session

$250

90 Minutes

During this time I will begin to learn your story. We will cover logistical information, review your intake and completed inventories. I always try to leave room for any additional questions, concerns, or comments.

Individual Therapy

$135- $165- $195

55 Minutes


$250

85-90 Minutes

I also offer extended and brief sessions. Please inquire if interested.

Redistribution Fee (Community Care Fee) $250 - Optional. For those who have more access to power & privilege. Subsidize therapy for someone else.

Pro-Bono Work

At moment the all reduced rate spots are full.

In an effort to reduce financial barriers and increase access to quality mental healthcare. I reserve a limited number of reduced-rate spots for those who cannot pay the rates listed above.

What is an "Out of Network" provider?

Basically, I don't have an agreement with your health insurance, and I set my professional fees.

Questions to ask your insurance company:

  • Does my plan cover CPT codes (your insurance provider will know what that means) 90791 and 90837?

  • Has my deductible been met this year? If not, how much is left?

  • Am I eligible for Telehealth mental health services?

  • What is my out-of-network deductible for outpatient mental health?

  • What is my out-of-network coinsurance for outpatient mental health?

  • Is there a limit to the number of sessions I am allowed?

  • Do I need a referral from an in-network provider to see someone out-of-network?

  • How do I submit claim forms for reimbursement?


Some Benefits of Private Pay

  • No diagnosis is required for services.

To bill an insurance company, you will have to receive a diagnosis. This means that insurance will have a record that will contain your information. Unfortunately, this can give you a "pre-existing condition." It isn't terrible from a mental health perspective; however, not everyone feels that way about mental health diagnoses.

  • Confidentiality

Health Insurance companies have access to your information. In the case of an audit, they have access to all of your private details.

  • The decision to control your therapeutic journey.

Some insurance companies only provide a limited number of sessions. I mean, how is that fair? Insurance companies may also try to push therapeutic approaches that do not tailor to your specific needs, as they do not consider your identity.

Insurance companies require that a treatment plan be submitted to approve the number of sessions, and ultimately, they use this to determine how your time in therapy is spent. A claims specialist determines the number of sessions (a non-mental health professional you have never met and does not know your presenting concerns and history) and is not based on need and your goals for therapy.

  • Avoid surprise costs

Insurance companies will warn you, "A quote for benefits does not guarantee payment…." This means that despite being told verbally (over the phone) that something is covered and possibly even being given an authorization number, you can still be denied once they review the diagnosis. 

If you attend therapy sessions under the belief you are using health insurance to cover your visit, and your therapist receives a denial of the claim, you are still responsible for the full payment of your sessions. At the same time, your treatment is likely interrupted (unless you choose to continue paying out of pocket). You can attempt to appeal the claim with your insurance company, but be prepared to go through several levels of appeals, which can take weeks to months – all.

After reading, if you have any more questions, I encourage you to contact your insurance provider to learn more about your Out-of-Network providers and benefits. You may often be able to reimburse for a portion of your services through a Superbill (I will be happy to explain that more in detail).

Good Faith Estimate

Good Faith Estimate Information

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.

Policies

Payment Methods: I accept American Express, Discover, Mastercard, and Visa. You may request to use your HSA (Health Spending Account) and FSA (Flexible Spending Account) to pay for services. Please get in touch with your HSA or FSA company regarding questions related to covered funds. Additionally, I accept voucher payments and mutual aid funds.

All payments are processed via Ivy Pay or Simple Practice, a HIPAA complaint platform. I do not accept payments via PayPal, Venmo, CashApp, check, or cash.

Any Other Questions for a Mental Health Counselor in Fayetteville, NC and Colorado?

Please contact The Virtual Couch with any additional questions you may have.

I look forward to hearing from you!