Services may be covered in full or in part by your health insurance or employee benefit plan. Please check your coverage carefully by asking the following questions:
- Do I have mental health insurance benefits?
- What is my deductible and has it been met?
- How many sessions per year does my health insurance cover?
- What is the coverage amount per therapy session?
- Is approval required from my primary care physician?
You can find answers to these questions by calling the number on the back of your insurance card under “behavioral health” or “mental health/substance abuse”.
I take the following insurances at this time:
- BlueCross and/or BlueShield
- Highmark BC/BS (Medicare)
- Keystone Health Plan East
- Magellan Behavioral Health
- Most Union Funded Insurances
- Penn Behavioral Health
- Personal Choice
- Out of Network
If you don’t have these insurances, please be sure to still check with your insurance, as you may still be able to see me on an “Out of Network” basis.
Please note that I do not take Keystone Mercy, Aetna Better Health, or other Medicaid-funded insurances.
Rates for those wanting sessions without insurance coverage
$110 per 45-minute session. $140 for an initial evaluation.
Why would I want to pay for psychotherapy at the regular rate when I can use health insurance and pay lower co-pays?
I believe in giving my clients informed choices. On one hand, insurance does allow you to pay less out of pocket. However, before you decide whether to use your health insurance to cover psychotherapy, consider two problems related to using it.
Intrusion in your psychotherapy
Psychotherapy works best when all important communications remain between the therapist and the client (or clients in the case of family or couples therapy). This arrangement insures a safe environment where problems can be fully explored and privacy is secure.
Managed care tries to contain costs by setting some limits on care, whether they be absolute limits on the number of sessions, types of therapies available to clients, or limits on therapy beyond that which is “medically necessary” (as they define it) to prevent crisis-related psychiatric deterioration. These companies have become actively involved in what happens in psychotherapy treatment, and if you use insurance, they will have permission to request records and to speak with me directly about all aspects of your care. They will also be able to give directions to what should be done in your therapy, tying further payment for services to whether or not those things are done. In an effort to decide who needs care and how much of it they need, managed care companies have appointed gatekeepers and reviewers to help with decisions about what they define as “medically-necessary” therapy. As a former gatekeeper/reviewer in a previous position, I have been in this very position. Use of insurance is controversial in the field of psychotherapy. Many psychotherapists believe that the gatekeeping and review functions interfere with the basic premise of the safe, confidential environment that is fundamental to the psychotherapy process. Some have argued that the gatekeeping function is damaging to the healing process itself. Many mental health professionals are concerned that cost containment is receiving a higher priority than mental wellness. On the other hand, there is an argument that by setting these limits, clients are assured of only enough service that is necessary.
As a therapist, I am very comfortable telling clients when I think they are ready to move on, and I do not believe in the idea of lifetime therapy. I believe that as long as there is a goal on the part of the client, however, that they should have access to care. Either way, I want the client to be the one who decides what they need.
Confidentiality of records.
In order for you, as an individual, to get health insurance benefits, the therapist or clinician is required to make a formal diagnosis. This diagnosis becomes part of your permanent record to be looked at when it is revealed to your insurance company, and it can be accessed by other insurance or managed care companies-or even by others who might be interested and who gain consent. This becomes an issue when applying for security-conscious positions, other health insurances, and life insurance. By choosing to pay out of pocket, your health insurance company will not have access to your confidential information, including your diagnosis.
IS IT WORTH IT TO USE INSURANCE?
This is a personal choice, which I am not coming down on either way. Factors including cost, convenience, confidentiality, and involving third parties plays a role in decision making. I can certainly work with people who choose to use insurance, and those who do not. I have no preferential treatment for either. In the end, however, I like giving people informed choice about these options.
Reduced fee services are available on a limited basis for people who do not have insurance and can be discussed when you set up an initial evaluation. Income verification for the household will be requested and required.
Cash, check and major credit cards (Master Card, Visa, Discover) are accepted for payment. Payment of co-pays and/or fees is due at the time of service. Lack of payment may be cause for rescheduling a session, and a pattern of a lack of payment may be cause for a referral to be made to receive therapy elsewhere.
If you do not show up for your scheduled therapy appointment, and you have not notified us at least 48 hours in advance, late fees will apply. This is done for two main reasons: the lesser one is that it gives others who are waiting for an appointment an opportunity to be scheduled for that appointment, and the greater one is that sometimes in therapy, people have days where they don’t want to talk about what is bothering them. This is normal and expected, and I’d rather agree to spend a session helping people cope by focusing on something else than not seeing a person at all. That session is part of the process of getting better through learning to cope.
Set up an Initial Appointment
Request a therapy appointment by calling the office at 610-626-8085. Push the prompt for “New Patient”.
Questions? Please contact the office at 610-626-8085 for further information.