Session rates are:
Initial Assessment (Session): 45-50 minutes: $160
Individual Therapy Sessions: 45-50 minutes: $130
Group Therapy Sessions: See group details.
Session fees/co-pays/co-insurance are due at time of service.
Disability Determination Forms: Providers must meet with clients a minimum of 3 sessions to gather information to assist this process; it still may be determined that additional sessions are required to obtain information. Clients must also be under the care of a medical doctor, so documentation by providers is a supplement to a physician's information. Providers cannot guarantee that a client will be approved by a Disability company or organization. Completing forms, mailing and/or faxing information require the provider to dedicate extra time outside of scheduled sessions; Admin staff, office supplies and resources may be utilized as well.
Fees associated with this process:
- Cost to complete Disability forms: $45
- Faxing or Mailing of Disability forms: $.35 per page
- Mailing of Forms: $ Cost of Postage
New Day High Point, PLLC will invoice the client for fees associated with Disability Determination process, (unless the Disability Management Company/Organization requests to be invoiced for fees).
Participating Insurance Panels:
(Provider coverage is listed below each Insurance name)
Blue Cross Blue Shield plans (PPO, Blue Value POS, Indemnity)
CBHA Insurance (This is the Medcost Plan managed by CBHA for Wake Forest, UNC and ECU Employees)
Out of Network (Please see below for more on obtaining a Superbill for your insurance plan)
Because each insurance plan is a little different, it’s still a good idea to contact your insurance company to verify your benefits and find out how they (Insurance) pay for services (therapy). We will also check your insurance benefits based on information provided, but we sometimes find that benefit information is only an estimate for services provided. If we determine that your insurance benefit is different from the original estimate, we will notify you immediately of any changes. It’s not pleasant to have surprises where you have to pay unexpected amounts after your therapy sessions have begun; if we find that there is a balance due, you will be responsible for these charges, however, we will make every effort to work with you to bring your balance up to $0. Also, if we find out that you have a credit, we will notify you if this change and this can be applied to future sessions or return to you as a refund.
How to verify your benefits?
- Call your Insurance company and ask if your plan covers Mental Health or Behavioral Health benefits?
- Ask if your plan has a deductible? If so, ask if you have met any amount towards the deductible? Sometimes there is an individual and/or a family deductible. Ask if you have one or both?
- Ask if you have a co-pay or co-insurance? If so, ask what the co-pay or co-insurance is for therapy sessions?
- Ask if you have to have a referral or a prior authorization before you see us (or a therapist)?
- Ask if there are any limits to how many sessions you can have in a calendar year? If so, how many? Sometimes there is an initial limit but there can be a request for more sessions if they are needed.
- Ask if there is anything your plan does not cover for therapy (unusual, but sometimes they do not cover a certain diagnosis)?
If we are not “In-Network” as a provider with your insurance plan:
- Ask if you have Out of Network benefits (OON)?
- If you have OON benefits, ask if you need to have a referral or an authorization to use these benefits?
- Ask how much they will reimburse you for your therapy sessions? A certain % is typical.
- Ask them how to send in claims to be reimbursed? Sometimes they have a fax # or address that they will provide so you can be reimbursed.
- If you are utilizing OON benefits for your therapy sessions, you will be expected to pay the full session fee at the time of service. I will provide you with what’s called a ‘superbill’ to submit to your insurance company.
**A ‘superbill’ is similar to a detailed receipt that you can send to your insurance company, so that they will reimburse you.