Fees and insurance.
I treat mostly self-pay patients at Brookline Therapy and I provide statements with all the required codes that can be submitted for reimbursement by insurance plans with policies that provide out-of-network benefits. Unfortunately, I am not a provider for any HMO products including Medicare. I leave it up to you to ensure you are entitled to reimbursement from your specific insurance policy and to pay for services rendered.
I can accept checks, cash and some credit cards (Visa and MasterCard). Payment is expected at the time of your appointment.
How to follow up with your insurance company.
I suggest you call your insurance company to find out about what benefits you have for out-of-network reimbursement. Use the toll free number (usually found on the back of your insurance card) and speak with a plan representative. Have a pen and pad ready so you can take down the information that the representative gives you.
If you are coming to see me for individual therapy, inform the representative that you are planning on first accessing an Individual Initial Evaluation (CPT Code 90791) and then ongoing Individual Therapy (CPT code 90834). You are asking about outpatient mental health services.
Tell the representative that you will be seeing Marjorie Siegel, LICSW. I am considered an “out-of-network” provider. I will provide you with a receipt to submit to your insurance company.
The following are other specific questions to ask the representative:
- Is there a deductible?
- What is the deductible period?
- Is it a calendar year or is the period calculated on a different schedule? For example, many plans for school or college employees run on a school calendar.
- How much is the deductible?
- How much of that deductible has been met?
- What percentage will your insurance company pay for each session?
- Is this percentage based on the actual amount that the clinician bills for his services?
- What is the maximum number of sessions allowed per year?
- Is pre-approval or pre-certification required by the plan?
- If so, what is the procedure for pre-approval or pre-certification?
With the answers to these questions, you should have a good sense of what benefits will be paid to you and what portion of our sessions you will have to pay out of pocket. I look forward to seeing you.
Appointment times are reserved in advance. A minimum of two business days (48 hours) notice for cancellations is required. Appointments that are missed without 48 hours notice will be charged at the full session rate.
Your sessions are confidential and my practice complies with the privacy rules established under HIPAA, the Health Insurance Portability and Accountability Act. The Notice of Privacy Practices describes the circumstances under which clinical social workers are mandated or allowed to use or disclose psychiatric information. This notice is given to all new patients, and a copy is available upon request.
Contact outside of your sessions.
For scheduling changes I am available by telephone, text or in person. Telephone messages and emails will be returned within 24 hours on business days. I am available by phone or email for urgent matters and will return messages as soon as possible but may not be able to respond immediately. People experiencing an emergency who are unable to reach me immediately are instructed to call 911 or to go to the nearest emergency room.