January 2014 - Know your Deductible!

For most insurance companies, the beginning of the new year means that deductibles are often reset to zero. This can have a significant impact on the costs that clients are responsible for at the time of service. For instance, clients that had previously met their deductible at the middle or end of the year may not have had to pay anything for counseling or, in some cases, a small amount. This made receiving counseling services convenient to the client and the counselor.

Now that 2014 is right around the corner, clients need to be aware that they may have to meet their deductible again, which means that they will have to pay out-of-pocket for counseling until there deductible is met. In my practice, payment is always due on the date of service. Therefore, I make it convenient for clients to make payment before or at the session by accepting:

 

• Cash
• Check
• Credit Cards
• Paypal

 

Remember that all insurance companies and even policies within insurance companies are different. As a client, it is your responsibility to know your deductible and copay and whether or not you will be responsible for (a) paying the full amount or (b) paying a co-pay. Keep in mind that co-pays are sometimes a set number (i.e., $25) and sometimes a percent (i.e., 20%). To help clients, I have made a simple check list of questions to ask your insurance carrier before your first counseling appointment:

  

1. Do I have Mental Health/Nervous coverage for outpatient psychotherapy in an office?
2. Does my policy cover individual, family/couple, or both?
3. Are there any pre-existing conditions clause(s) that may interfere with coverage?
4. What is my deductible? Am I required to meet my deductible? (Some plans waive the deductible and may only require a copay. On some policies, the deductible is waived and there is no co-pay!).
5. Will I need to pay a copay? If so, what is my copay for a Licensed Professional Counselor (LPC)?
6. Do I need prior authorization for outpatient psychotherapy?
7. Are there any limits on the number of visits that I have per calendar year?

 

I hope that these questions are helpful in determining your coverage. As a new or existing client, it is always the client’s responsibility for knowing and understanding their insurance policies and coverage.

 Once the New Year arrives, I require all clients to pay for services at the appointment regardless of their insurance. The purpose of this policy is to ensure that payment is received promptly and to prevent clients from accumulating a large balance (that may results if the insurance company does not pay!). This is beneficial for both the counselor and the client. If the insurance company does provide payment for services, a reimbursement check is either sent to the client or a credit is issued to their account at the discretion of the client.  

If you have any questions about this, please feel free to contact my office.

Sincerely,

Jeremy H. Broussard, PhD, LPC