Do you take insurance or do I have to use my insurance?
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?
What’s it like to engage in therapy?
What about medication vs. psychotherapy?
Does what we talk about in therapy remain confidential?
- 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. **