BLUE CROSS & BLUE SHIELD - DEAN HEALTH PLAN - MHS HEALTH -TRICARE MILITARY

Payment & Fees

HEALTH SAVINGS ACCOUNT (HSA)

Please keep in mind that you can use your pre-tax Health Savings and/or Flexible Spending Account funds (HSA/FSA) to pay for psychotherapy services.

SELF-PAY

If you choose to self-pay, you will typically be charged for services within 24 hours after your appointment using the credit/debit or HSA/FSA card you have on file with my practice (see FEE SCHEDULE below).

REDUCED/ADJUSTED FEE

Just as insurance companies negotiate reimbursement rates/fees in order for me to be credentialed with them as a participating provider, I am also open to negotiating a reduced/adjusted fee for individuals who choose to pay out-of-pocket. This will be addressed on a case-by-case basis and will be decided based on multiple variables (e.g., financial hardship, income, severity of presenting problem and access to treatment, etc.). Please do not hesitate to inquire with me about this before making a decision not to enter into treatment due to cost. If we are unable to reach an equitable adjusted fee, I will assist you with locating other providers in the community.

INSURANCE: Plans Accepted

I currently accept the following insurance plans:

  • Blue Cross & Blue Shield: In-network participating provider for most BCBS plans, including Anthem.
  • Dean Health Plan (Janesville office only)
  • MHS Health Wisconsin
  • TRICARE Select (PPO): No referral required.
  • TRICARE Prime (HMO): Referral from your physician required.
  • Wisconsin Medicaid (BadgerCare/ForwardHealth): Credentialed Medicaid provider.

INSURANCE: Be Informed

  • IMPORTANT: Because of the differences between insurance plans, I strongly encourage you to call your insurance provider prior to your first visit with me so you are fully informed about your financial responsibilities.
  • WISCONSIN MEDICAID (ForwardHealth/BadgerCare): Although I am credentialed as a Medicaid provider, I am also required to be a participating provider with your selected Medicaid HMO in order to get paid for the services I provide to you. If I am not credentialed with your selected Medicaid HMO, you can call ForwardHealth Member Services (800-362-3002) to discuss your options.
  • INSURANCE, IN-NETWORK: If I am credentialed with your insurance as a participating provider under your plan, I will electronically submit your claim on your behalf. You will be responsible for any fees or portions of fees not paid by your insurance (e.g., co-pays, co-insurance, deductible, etc.).
  • INSURANCE, OUT-OF-NETWORK: If I am not credntialed with your insurance as a participating provider under your plan, my services may not be covered OR may be covered if you obtain prior authorization from your insurance provider. You will be responsible for the full fee at time of service, but I will provide you with special documentation (e.g., "super bill") that you can submit to your insurance to request reimbursement. In some cases, I may be able to submit directly to your insurance on your behalf, but this varies depending on your insurance and you will still be responsible for fees or portions of fees not paid by your insurance (e.g., co-pays, co-insurance, deductible, balance billing, etc.).

FEE SCHEDULE

  • New Patient Intake Assessment: $250
  • Individual/Couples Psychotherapy: $200 per session.
  • Group Psychotherapy: $75 per session.
  • Consultation (self-pay): $200 per hour with a minimum fee of $300 and then prorated every 15 minutes after the first two hours. For consultation that does not take place at my office, I also charge for mileage ($0.55 per mile).
  • Psychological Evaluations (self-pay): Fee varies depending on the type of evaluation and whether a full written report will be required (e.g., court ordered evaluations). Evaluations typically cost $2,000. You will be informed of the cost after our initial consultation and before moving forward with the evaluation process. The initial consultation fee is $200 and will be charged at time of service. Evaluations may be paid in two installments, half up front and the remaining half when the written report is completed.