FREQUENTLY ASKED QUESTIONS
Do you take insurance or do I have to use my insurance?
Due to our therapists being in network with various insurance providers, please check their individual bio page for details on what insurances, if any, they accept. If you have another insurance that one of our clinicians does not accept, we will be happy to provide you with a “superbill” that you may submit to your insurance company for potential reimbursement.
Please note: All Traditional Chinese Medicine (TCM) treatments are considered Out of Network (OON) for insurance. However, we are happy to provide you with a superbill that has the necessary coding for you to submit to your insurance provider for potential reimbursement. Additionally, Couples Therapy is not covered by insurance, as there is no billing code for couple’s therapy and there is no use of diagnosis.
If you choose to not use your insurance: Many people choose not to use their insurance for numerous reasons. When you use your benefits, your insurance requires a diagnosis and they can control how you receive therapy, which includes, how many sessions you need and how long your sessions should last. Your therapy is sacred; however, when you choose to use your insurance, there is a third party involved in this personal process and it is subject to review when they deem necessary. When you choose to opt out of using your insurance, the choice goes back into your hands. Meaning, you get to decide what feels best for you and you may experience better results.
Good Faith Estimate:
Beginning 01/01/2022, therapists and other health care providers are required by law to give uninsured and self-pay clients a Good Faith Estimate (GFE) of costs for services that they offer, when scheduling care or when the patient requests an estimate.
A good faith estimate (GFE) is a document that outlines the estimated costs and terms of receiving services from a healthcare provider. This enables clients the opportunity to compare pricing among different providers by giving detailed information regarding services and costs of services received at each provider’s location. The costs noted on the Good Faith Estimate are estimates based on service pricing at the time the estimate is given. The final costs for services may be higher based on when the services are provided and the duration of the services. If this happens, federal law allows you to dispute (appeal) the bill.
The Good Faith Estimate is not a contract. Which means you are not required to obtain the items or services provided by Higgins Wellness listed in the Good Faith Estimate.
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 the 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.
To learn more about disputes and get a form to start the process, go to www.cms.gov/nosurprises or call 1-800-985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059.
Why do people go to therapy and how do I know if it is right for me?
People have many different motivations for engaging in therapy. Some may be going through a major life transition like divorce, loss of a job or they may not be handling stressful circumstances well. Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, substance use, and relationship problems. Therapy can help provide some much needed encouragement and help with skills to get them through these periods. Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life. In short, people seeking therapy are ready to meet the challenges in their lives and ready to make changes in their lives.
What’s it like to engage in therapy?
It’s always best to know that therapy isn’t always happy and exciting. Sometimes, it can be down right tough. Most of us know that there is always light at the end of the tunnel and therapy can be just that. It may have difficult periods but don’t give up. The outcome is worth it in the end.
What about medication vs. psychotherapy?
It is well established that the long-term solution to mental and emotional struggles and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom(s), therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor, you can determine what’s best for you. In some cases a combination of medication and therapy is the right course of action.
Does what we talk about in therapy remain confidential?
Confidentiality is a cornerstone of appropriate mental health care, and is also protected by the law. Thus, we generally can only release information about our work with written permission. Several exceptions do exist. For example, insurance companies generally require some basic information if you choose to seek reimbursement. Electronic Health Records are also third parties that are subject to similar confidentiality standards. Additionally, there are several instances in which mental health professionals are required by law to report or take action:
- Making provisions for your safety if there is a threat of imminent harm to yourself.
- Taking protective actions (including notifying potential victims or police) if there is a threat of serious bodily harm to others.
- Reporting potential child, elder, or dependent abuse.
- Legal testimony if subpoenaed/ordered by a court.
- Assisting in accessing services if a patient is unable to meet their basic needs (including food, clothing, and/or shelter) due to a mental illness.
** Please note that these exceptions are rare and it is our goal to always maintain strict confidentiality. **
What is your cancellation and rescheduling policy?
If you need to cancel or reschedule an appointment, we ask that you give greater than a 24-hour notice. If it is less than 24 hours or a no show, then you will be charged the full fee of the service. You may always contact us via the form here or leave a voicemail 24/7.
What is the Good Faith Estimate (GFE)?
This Good Faith Estimate is a document that outlines the estimated costs and terms of receiving services from a healthcare provider. This enables clients the opportunity to compare pricing among different providers by giving detailed information regarding services and costs of services received at each provider’s location. The costs noted on the Good Faith Estimate are estimates based on service pricing at the time the estimate is given. The final costs for services may be higher based on when the services are provided and the duration of the services. If this happens, federal law allows you to dispute (appeal) the bill.
The Good Faith Estimate is not a contract. Which means you are not required to obtain the items or services provided by Higgins Wellness listed in the Good Faith Estimate.
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 the 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.
To learn more about disputes and get a form to start the process, go to www.cms.gov/nosurprises or call 1-800-985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 1-800-985-3059.