insurance reimbursement

We are currently considered out of network providers for most PPO plans and are not paneled with health insurance plans. We can provide clients with a form, labeled a "superbill", for clients to submit to their health insurance for possible reimbursement. If a client is unsure of their benefits and coverage, contacting their insurance company and inquiring about "out of network benefits" can be helpful.  In some cases, insurance companies may authorize a "single case agreement", as well.  

Benefits of our practice being private pay include therapy being driven by the client and what we as therapists recommend - we are not bound by session limits set by insurance companies and can have client's best interest in mind.  When therapy sessions are submitted through insurance they may cost more due to high deductibles.  At Genuine Self Therapy, we want to provide a high level of care at a reasonable cost so that we can meet our clients' needs.   Please contact us with any questions or concerns you might have regarding this. 

no surprise act and good faith estimate

A client has the right to be provided a Good Faith Estimate to protect a client from unanticipated costs of therapy.  A Good Faith Estimate shows the costs of services that are reasonably estimated for the expected services to address a client's mental health care needs. The estimate is based on the information known to the therapists at Genuine Self Therapy when the estimate is completed.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. A client could be charged more if complications or special circumstances occur. If this happens, federal law allows clients to dispute (appeal) the bill.  If a client is billed for more than this Good Faith Estimate, the client has the right to dispute the bill.

A client may start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If a client chooses to use the dispute resolution process, the client 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 the dispute agrees, clients will have to pay the price on the Good Faith Estimate. If the agency disagrees with the client and agrees with the health care provider or facility, the client will have to pay the higher amount.

To learn more and get a form to start the process, go to:
www.cms.gov/nosurprises or call CMS at 1-800-985-3059.

For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call CMS at 1-800-985-3059 .

This Good Faith Estimate is not a contract. It does not obligate clients to accept the services from Genuine Self Therapy.