As of September 1, 2021, I accept Kaiser Permanente, ACI Specialty, and CalVCB Victims Compensation. All of these insurances require prior authorization so please contact them for assessment and authorization before you call me for an appointment. I also accept returning clients on Magellan (Blue Shield of CA; Western Health Advantage, & EAP). If you were to be a new client of Magellan and really want to work with me, please call me and we'll figure out a solution.
Yes. In California, telehealth (meeting for psychotherapy sessions online in a video-conference format) is reimbursed by the insurance companies that I work with. Telehealth does not put any more financial burden on you than an in-person appointment. In fact, in 2021, and likely moving to 2022 as well, Kaiser Permanente waives your copay (not your deductible!) if you do therapy online. Magellan doesn't.
EAP through ACI Specialty and Magellan do not have any copays.
Insurance does not pay for your missed sessions. If you have Magellan, you pay me a $63 late fee. If you have ACI, you don't pay me late fee but you lose that session. Kaiser does not allow me to charge a late fee but I can and will refer you back to Kaiser if you keep missing your sessions or cancel late. Cancellations and missed sessions suggest that you either don't need (any more) therapy sessions or what you are getting is not really benefitting you.
You pay me the copay for each session that your insurance plan has established. That's usually the same amount that your regular office visit. If you have high deductibles, you will end up paying me my contracted fees with Kaiser or Magellan. Inquire with me how much that would be. I cannot give you information on your insurance plan and whether you have deductibles. For that, please call your insurance plan's members services. Any payment is due at the time of your session. You can pay with ATM card, credit card or health savings account.
The pros is that you are likely to get psychotherapy cheaper than you would if you were to pay out of pocket: at the cost of you copay. But this may not be true if you have high deductible ("low" monthly premium). In this case, you'd have to pay my contracted fee, which may be higher than what you could bargain for if you were to pay out of pocket.
The cons is that you are subject to "medical necessity" requirements. Some kind of sessions such as family/couples counseling or online therapy, may not be covered by your specific plan.
And the biggest drawback is the insurance companies' overview of your records. Once they pay for your sessions, they have full access to your medical records and at that point, you can't opt out. This is true for health insurance as well as EAP reimbursement.
Some people, depending on their job titles, may get hurt. I've had people requesting the medical records to get the job they have interviewed for. The Court can also summon the medical records if you are suing or you are sued. I've had that in child custody cases. If you are applying for citizenship or your immigration status is in question, you may want to think about how your mental health records may affect your case.
Medical necessity is the insurance companies' requirement for treatment reimbursement. You have to have mental health symptoms severe enough that require professional intervention; the symptoms have to be known "responsive" to psychotherapy techniques; and we have to follow an evidence-based treatment plan and show progress.
Hence the problem with the no-shows or frequent cancellations of sessions. Would you (regularly) cancel or no-show for a medical appointment that you have been waiting for a week if you were really in pain? If you cancel your appointments for any reason, ask yourself how important these sessions are to you. If you don't think you are making progress, please let me know so we can change direction or find you another therapist where you can get ahead so neither of us would spend time in vain.
Important fact about insurance reimbursement: you, the insured, is still the primary responsible party for the payment of your session fees. I file for reimbursement on your behalf but if, for any reason, they refuse to pay, you are responsible for paying my fees and I have the right to stop services if you refuse to pay.
My regular fee, if you want to pay out of pocket, is $85 for 30 minutes, $130 for 60 minutes, and $190 for 90 minutes. If you pay 6 sessions at once, I give you the 7th session of the same length for free.
On occasion, I may consider sliding scale fee if you are on a restricted budget (pay-6-get-1- free offer would not apply in this case).
However, there is no sliding scale for insurance. I charge your copays and deductible fee according to my contract with that specific insurance company - no more, no less.