PAYMENT DUE:
All payments are due at the time of service unless other arrangements are made in advance.
CREDIT CARDS:
We take Visa and Mastercard (or cash) only. Our policy is not to take checks. If this is impossible, please speak to Dr. Kanter who may be able to make separate arrangements.
MANAGED CARE:
We bill most insurance plans, though please note if you have a managed care plan, we may not be a participating provider. You are responsible for copayments, deductibles, or amounts not covered by insurance.
BLUE CROSS:
For certain providers and certain services, we may be able to accept Blue Cross Blue-Shield Blue Choice PPO (and occasionally Health Options HMO for testing as a result of a medical condition only ). Please check with Dr. Kanter if you have Blue Options insurance as your out of network benefits may be comparable to your in-network benefits.
AUTO INSURANCE:
We do see patients who are covered by their auto insurance or auto insurance PIP if it has not been exhausted. We bill auto insurance, but as with all insurance, you are responsible for your co-payments.
MEDICAID/STAYWELL (Harmony/HealthEase):
We (and most other psychologists) are not eligible to obtain reimbursement from regular Medicaid (which includes Amerigroup) either as the only insurance or as a Medicare secondary insurance. We DO accept the Medicaid HMO: STAYWELL (also known as Harmony or HealthEase Medicaid) for individual and family psychotherapy as well as Psychological Testing/Evaluations.
MEDICARE:
We do accept Medicare, and typically, if you have a Medicare Supplemental insurance, there is not likely to be any co-payment. Rarely, a supplemental (like GEHA) may not fully cover the cost of the remainder above and beyond what Medicare will pay and so, in such instances, you may have a very small co-payment. Please note that a second (or secondary) insurance does not always cover the cost of what Medicare does not cover if you do not have a "Supplemental" insurance poicy. In such instances, we may not be providers for the secondary insurance and/or insurance authorization may be required which may or may not be able to be obtained or which may not cover the full cost of the remainder left over from Medicare. If you do not have a Medicare Supplemental or a secondary insurance (i.e. you have Medicare only, or Medicare and Medicaid), Medicare requires a 20% co-payment for psychological or neuropsychological testing and a 50% copayment for mental health services (typically about $45 to $55 per session for psychotherapy).
WORKER'S COMP:
We do see Worker's Compensation cases but require proper prior authorization before an appointment can be scheduled.
ALLOWABLE FEES:
Generally, if you do not have an HMO or managed care plan, and you do have mental health benefits, your insurance should cover some part of our services. If we are a participating provider, your fee and co-payment will offer a discount relative to our usual and customary fees. If we are not a participating provider, you will be responsible for the difference between what insurance pays and our usual and customary fees.
COUPLES THERAPY:
Many insurance companies do not cover marital or couples therapy. Billing for marital/couples therapy as individual therapy is fraudulent, so if your plan does not cover it, please do not ask us to do so. We encourage private payment for marital therapy to maximize confidentiality.
SUBSTANCE TREATMENT:
Alcohol and drug treatment benefits may be more limited in some plans than other mental health benefits.
MENTAL HEALTH PARITY:
Mental health benefits are usually subject to higher deductibles, more limited treatment, greater restrictions, and higher co-payments than other health benefits. This is why psychologists have lobbied hard through the American Psychological Association and your local congressmen and congresswomen for "Mental Health Parity" to make it illegal for insurance companies to change benefits soley due to mental health issues. Studies show increasing such benefits to patients will usually reduce overall healthcare costs. We applaud our congressmen and women for recently passing Mental Health Parity legislation (July, 2008) which wil be phased in over the next several years.
