Beautiful Landscape

FREQUENTLY ASKED QUESTIONS

In this section, you will find answers to common questions about therapy and insurance. If you still have questions, please contact us.

HOW MUCH DOES THERAPY COST?


  • Initial appointment (60-90 minutes): $225

  • Additional appointment (55 minutes) $200

Fees are the same for all clinicians and for all types of sessions (Individual, couples, psychological testing, etc.). Generally, sessions are 55 minutes. Shorter sessions are not common but fees are reduced accordingly. Most people use health insurance to pay a portion of the cost.




HOW OFTEN DO I NEED TO HAVE THERAPY?


This will vary significantly with your treatment goals and can range from every two weeks to more than once per week. Most therapy is generally weekly and then reduced to less often as you begin to make progress. Some goals can be accomplished relatively quickly in just a few sessions. Most people attend therapy for several months to reach maximum benefit.




DO YOU TAKE INSURANCE?


We are in network with many insurance companies including:

  • Blue Cross Blue Shield
  • Cigna
  • Medcost
  • Medicare
  • Tricare
  • United Health Care/ UMR/Optum

We do not accept Medicaid.

It is important for you to understand your insurance benefits because you are responsible for payment of the portion not paid by insurance. Our office staff are happy to help you check with your insurance to determine your out of pocket costs.




HOW DOES MY INSURANCE WORK?


Good question. Taking a moment to understand your insurance benefits will help you know what to expect. We suggest you familiarize yourself with these key terms:

In Network and Out of Network benefits

In network means that we have contracted with the insurance company to provide services for individuals who have that insurance. Out of network means we are not contracted with your insurance company. Some insurance policies include reimbursing you for some portion of an out of network provider’s services, although you typically are responsible for filing that claim with the insurance company in order to be reimbursed.

Primary and Secondary Insurance

Most people have only one insurance, a primary insurance, which pays a portion of the fee. Usually this is through the individual’s employer (or family member’s employer), purchased individually through the Affordable Health Care Act, or a government program.

Some people (mostly retirees) have a secondary insurance which can be filed after the primary has paid and which may pay an additional amount toward the fee). We are happy to file both.

Medicare Replacement plan

Individuals who qualify for Medicare have the option of selecting a replacement plan through a private insurance company, such as UHC or Humana. Reimbursement for services through these plans requires you see a provider who is both a provider for Medicare and for the private insurance.

Supplemental plan

Supplemental insurance plans are basically secondary plans which are filed after the primary is paid and may pay additional an amount.

Dual plan

Dual plans are Medicaid plans which are combined with a private insurance. We do not accept Medicaid or any dual plans.

Allowable

The allowable amount is the amount we have contracted with your insurance company for the service if we are in network. It is always less than our fee, and we agree not to bill you for the difference in order to be in that insurance network. We are not limited by an allowable amount if we are not on your insurance network.

Adjustment

The adjustment is the amount you do NOT have to pay in we are in network with your insurance.

Copay/Coinsurance

Copays and co-insurance refer to the amount you have to pay for each session. Your insurance plan will have one or the other. Your copay is the fixed amount determined by your insurer you have to pay for each session regardless of the cost of the session. A co-insurance is a percentage of the allowable fee you have to pay for each session. Providers are required by the insurance company to collect the copay or co-insurance as part of our contract with your insurance company.

Deductible

Your deductible is the amount you have to pay out of pocket before your insurance pays anything at all. The amount of deductibles vary widely from $0 to thousands of dollars depending on your plan. It starts over every year.

Out of pocket limit

The out of pocket limit refers to the amount you have to file on insurance before your policy begins to pay 100% of expenses. It starts over every year.




DO YOU OFFER A SLIDING SCALE?


Wisdom Path does not offer a sliding scale for our services. Most insurance companies require that we use the same fee for everyone in order to be in network. However, we want to make our services available and realize some may not be able to afford the care they need. As a courtesy, we offer a scholarship fund and payment arrangements for those who qualify.




HOW DO I QUALIFY FOR THE SCHOLARSHIP FUND?


Wisdom Path, PLLC accepts donations for a Scholarship Fund for clients who are unable to pay for their treatment. If you need assistance, you can apply for the scholarship fund. If you meet criteria, some or all of the cost of services may be paid as long as there are funds available. You must re-apply every calendar year and provide documentation of eligibility in order to continue to receive scholarship funds.

Eligibility for Scholarship fund is determined by application from the client and based, in part, on federal poverty guidelines. Download Application for Scholarship Program here.




HOW DO I MAKE A PAYMENT ARRANGEMENT?


If you do not qualify for a scholarship fund or if the fund is depleted, existing clients may apply for a payment arrangement due to temporary hardship. Payment arrangements may include:

  • Temporary reduced out of pocket cost
  • Extended time to pay off the balance
  • Receiving services from an intern under supervision for no cost (when available)

Payment plans are requested by your therapist and reviewed/approved by the CEO based on your financial means, clinical need, and financial means of the agency. These are reviewed every three months. You are expected to be honoring the payment arrangement by being current on their payments as agreed in order to continue to have a payment arrangement. For those who require a payment arrangement because of a change in circumstances can speak with their therapist.