Insurance and Fees
Our services are often covered in part by insurance, HOWEVER…
Like a great many Psychologists at our level of training and experience, we do not accept insurance directly, but are considered an out-of-network provider for most PPO plans, and most flexible spending plans or HSA-Health Savings Accounts typically consider diagnosis related services rendered by a Licensed Psychologist to be qualifying expenses. Some flexible spending plans may also provide you with a debit card for ease of access for medical/therapy services. You certainly can use that card as well as most major credit cards to pay for your visits.
We do not call, write or fax insurance companies. Instead, we provide information directly to clients that can be shared with an insurance company. This might include an itemized invoice with all the necessary codes and numbers for reimbursement, or more detailed documentation that your insurance company may request. This gives you a chance to think about the implications prior to communicating the information to your insurance company.
Why we operate this way.......
Threat to confidentiality
Our filing insurance on your behalf severely jeopardizes your confidentiality. If we submit a bill to the insurance company on your behalf, your confidential information is processed by that company and then stored in a database. Anyone who is involved in the processing or handling of your claim may have access to your records and anyone who has a legitimate reason to access the medical database, such as future insurers and future employers, can view your confidential records.
Threat to future insurance etc.
The second reason we don't process insurance is because of the possible negative consequences to having a record of mental health services. Health insurance benefits can only be used to treat an illness. So, therapists are required to give a diagnosis that can forever be associated with a client. There are many examples of a mental health diagnosis affecting other aspects of a person's life. Some of these stories include being characterized as a high risk, resulting in increased premiums and even being denied life insurance or turned down for jobs that require a security clearance. If you do not use insurance, no one knows. Many people that we work with would just like new skills or some different strategies to try at home or school, these cases do not necessarily require a diagnosis.
Threat to our therapeutic relationship
When an insurance company underpays a claim, the billing therapist would have to ask the client for additional dollars. On the other hand when the company pays more than expected, clients or their families may believe the therapist was not completely honest with them. Both of these situations can interfere with our therapeutic partnership.
Changes in Health Insurance Industry
Finally, the health insurance industry has recently undergone drastic changes. Many people now have high deductible policies meaning we would be filing a diagnosis while no benefits would be paid during an entire treatment episode! Additionally, a majority of our patients (families) do not use insurance anyway.
The Value Proposition
In these difficult financial times, we feel it is important to stress that this practice has ALWAYS been devoted to providing the best value in the services we provide.
We strive to provide value in TOTAL DOLLARS INVESTED. Cognitive Behavior Therapy methods have been shown to be cost-effective and efficient. We believe that the addition of significant experience and specialization adds significant value for the dollar spent. Dr. Bauman provides concrete tools and strategies for use by our patients, parents, and teachers, so that most treatment actually takes place in real life. Therefore, in many cases, the total number of office visits may be far less than required with traditional psychotherapy.
Could you find less expensive, in-network services?
Yes, you may be able to go to an in network provider for small co-pays. We believe there is value in seeing a psychologist that you chose on factors often beyond insurance plan participation. Our fees are comparable to other senior level, out-of network psychologist specialists in this area. Our referrals DO NOT come from insurance companies. Our family of families do not often choose us because we have the lowest fees. Families choose us based upon reputation and professional quality. If you feel our fees are outside your budget, we also offer a 3 visit evaluate and refer package. Gain from Dr. Bauman's 20 plus year specialized experience while continuing the recommended treatment elsewhere.
For more information on fees and insurance policies or to schedule a convenient appointment, please click here or call us at (954) 659-0059.