Rates and insurance
WHAT IS THE COST AND DO YOU ACCEPT INSURANCE?
We are an out-of-network provider. The practitioners aren't in-network with any insurance. If you have out-of-network benefits for mental health, we can provide you with the forms to submit the claims to your insurance for reimbursement. There are several providers in the office, and visit costs range between $150 and $550, with average session cost of $200, depending on clinician, type of visit, and length of visit. Please use the Claimly tool on the bottom of this page to get more information about your insurance reimbursement or contact your health insurance provider directly.
Sliding scale available on case by case basis for patients without out of network insurance benefits.
Please call your insurance company to check:
- Do I have out-of-network benefits for mental health?
- Do I have a deductible for mental health services?
- At what rate will I be reimbursed for mental health services (the usual range is 50% to 80%)?
- Most insurances will pay the clinician directly, except for BCBS, which will send reimbursement check to the patient.
If you have a deductible, you’re responsible for paying in full for visits until the deductible is met. After the deductible is met your insurance will reimburse you for the portion of the visit cost that your particular plan approves.
Usually insurance will reimburse 50-80% of their "approved visit cost" or “customary amount.” The approved amount (or the customary amount) could be equal to or less than the visit cost. The percentage reimbursed is called the co-insurance, and it is dependent on the individual plan.
For example, a patient may have a $1,500 deductible and then their insurance will reimburse 70% of a $300 approved amount per visit. For $400 appointments, the patient is then responsible for paying in full for the first 5 visits. (The visit cost is $400, but insurance will apply $300 per visit to the deductible.) After the deductible is reached the patient would pay $190 per visit afterwards. The $190 reflects the 30% of the $300 plus the $100 that insurance didn't cover because it was above their "approved visit amount." Lower cost appointments are likely to get reimbursed at a higher rate as they fall under the customary “approved visit amount” of most insurance companies. In general appointments with all of our providers except for Dr. Lewis fall within the "customary amount" for most insurance plans
Patients pay our office in full and then receive checks from the insurance by mail.
CAN YOU TELL ME WHAT MY INSURANCE WILL PAY BEFORE I BOOK AN APPOINTMENT?
Insurance reimbursement is specific to your individual plan, so we’re unable to give estimates until we verify with your insurance after your first visit with us.
We are available to answer your insurance-related questions to the best of our ability. With any other questions regarding insurance and payments, please contact us at firstname.lastname@example.org.
How much would my visit cost?
If you’d like an estimate prior to joining the practice, please call the number on the back of your insurance card and ask the following questions:
Do I have out-of-network mental health coverage for office visits? If your insurance doesn't provide this, they will not reimburse anything for your appointments.
What is my remaining deductible for those services? Insurance will determine an amount per visit that they will use to determine reimbursement. It’s usually called the approved amount or the customary amount, and it differs by plan. It will not always be the full cost of the visit. You’ll pay our fee per visit out-of-pocket, and your insurance will apply the approved amount for each visit until your deductible is met.
WHAT'S MY CO-INSURANCE?
This will indicate the percentage of your insurance’s approved amount that they will reimburse after you’ve met your deductible.
WHAT IF I DON’T HAVE OUT-OF-NETWORK COVERAGE OR IF I HAVE A HIGH DEDUCTIBLE?
If you don’t have out-of-network coverage we won’t bill to your insurance because they won’t reimburse for your visits with us. If you have a high deductible, we will bill to decrease the deductible. Some of the practitioners accept sliding scale on a case by case basis. If you’re interested in sliding scale, please call 646.606.2663 ext. 801. Unfortunately we can’t commit to single case agreements at this time.
Unfortunately Medicare, Medicaid and Medicaid Managed Care Plans (i.e. United Health Community Plan), and Obama Care Exchange plans will not reimburse for out-of-network services.
get back from your insurance