Session rates are:
Initial Assessment (Session): 45-50 minutes: $175
Individual Therapy Sessions: 45-50 minutes: $170
Group Therapy Sessions: See group details.
Session fees, co-pays and/or co-insurance fees are due at time of service.
Participating Insurance Panels:
Our entire Group (New Day High Point, PLLC) is In-Network with **PPO, Blue Value POS, Indemnity
(**Blue Advantage, Blue Care, Blue Options, Blue Select, Blue Value, Classic Blue, North Carolina State Health Plan)
*Note: We are not paneled with "Blue Local" which is the plan connected with Wake Forest Health System. Only Wake Forest Health System can provide therapy services with Blue Local plans. We wish that we could offer this plan coverage, but this is a policy with BCBS of NC.*
(This is the Medcost Plan managed by CBHA for Wake Forest, UNC, and ECU Employees)
United Health Care
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)?
What if we are not “In-Network” 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.
Disability Determination Forms (including FMLA): We do not work with clients, just for the purpose of completing Disability Determination Forms/FMLA forms.
Completing these forms is up to each individual therapist working with NDHP. Some therapists have experience with this process and may decide to complete forms on a case by case basis with current/existing clients.
NDHP General process for therapists that decide to complete forms:
- Therapists typically need to meet with clients for 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 also must be under the care of a medical doctor, so documentation by providers is a supplement to a physician's primary information.
- Disability company plan case managers, legal counsel (client's attorney), collaborating physicians occasionally request additional letters and forms to be completed by therapists, often with little notice for the therapist. If this occurs, the therapist may require additional time, informing the requester, and the client of this necessity.
- If your therapist is out of the office at the time you are requesting paperwork to be completed, please contact your disability case manager, attorney, etc. to inform them that extra time will be required since your therapist is not in the office. Either your therapist or NDHP's Admin Team can provide you with an idea as to when your therapist will return to the office.
- Therapists cannot guarantee that the client's claim will be approved because there are no set standards for approving claims. Claim determination is dependent upon various company guidelines, the judge evaluating the claim (if relevant) & even the personal interpretation of the case manager reviewing your claim.
- To complete & submit client disability paperwork, therapists may end up playing 'phone tag' over the course of many days, may be required to set-up phone meetings to speak with case managers/collaborating providers, and sometimes receive letters from the disability company requesting more info, often with a 1-2 day notice.
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 & clients must agree to be charged as their therapist completes various aspects of this process. Clients will need to sign a form acknowledging this requirement if their therapist agrees to support this process.
- Completing disability forms: $60 (regardless of length)
- Writing a letter to support a disability claim: $30 (each individual letter)
- Phone calls/Phone Meetings: $20 for every 10 minutes of time
- Faxing or Mailing of Disability forms: $.35 per page
- Mailing of Forms: $ Cost of Postage