Are sessions covered by insurance?
Our practice is in-network with Blue Cross Blue Shield PPO and Blue Cross Blue Shield Blue Choice plans. If you have one of these, they will likely cover some portion, or all, of your therapy with us. We will help verify coverage for you but also ask that you do the same – we are not always given an accurate benefits quote and it is up to you to know the details of your insurance plan. We will provide you with instructions for verifying your coverage on your own at your request.
What if I don’t have Blue Cross Blue Shield?
That’s ok! We will still accept out of network insurance plans but you are responsible for submitting Superbills to your insurance company, who will then reimburse you directly if they cover sessions. We will provide you with those superbills. In these instances, we will charge our full out of pocket rate at time of service. So for example…you attend a therapy session and we charge you $145 that day, and the same thing happens for each session. Then, you receive a superbill that month that includes all of those sessions and you send that superbill directly to your insurance company. They then reimburse you directly if they cover a portion.
What are your out of pocket rates?
If insurance isn’t involved, we charge $160 for an intake session (your first session). For all sessions thereafter, we charge $145 per session. This is for both individual and couples therapy. We accept all major credit cards with the exception of Amex. Your credit card is stored in our secure system and it is charged immediately following your therapy session.
No Surprises Act
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes (under the law/when applicable) related costs like medical tests, prescription drugs, equipment, and hospital fees.
The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill.
If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate.
You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
Make sure your health care provider gives you a Good Faith Estimate within the following time frame:
If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;
If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of scheduling; or
If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided, within the specified time frames if the patient reschedules the requested item or service.
The No Surprises Act has a universal waiver form which Revive Relationship Therapy has adapted.
This is the public disclosure of the “Good Faith Estimate”
Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.