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About Insurance & Fees

Fees...

Standard rates for Monica Mayall, MA, LMFT, CHt

  • Initial Consultation/Intake: 90-minute session $150

  • Individual: 55-60 minute weekly session $125

  • Couples: 80-minute weekly session $200

  • Family: sessions with more than 2 people $200 + $50 per additional person

  • $25-$50 per group 80-120 minute weekly session

  • Some sliding scale spots available.

  • Cash, check, or Credit/Debit Card accepted at time of service.

  • Session fee will be charged to the client for appointments not canceled 24 hours in advance.

  • Legal Proceedings: $250 per hour to prepare reports and every hour required to be in court. Confidentiality will not be broken unless the client waives their privilege or therapist is ordered by a Judge. Therapists are not legally required (and are ethically discouraged) to break confidentiality when subpoenaed by a lawyer.

 

I am an in-network provider with Anthem Medi-cal, LACare Medi-Cal & HealthNet MHN Medi-cal.

For other insurance providers, the amount that your insurance company may reimburse you for these services is determined on a case by case basis by the insurance company when you submit a Superbill. See below for more information.

 

How Insurance Works...

 

In-Network Providers: Some therapists sign contracts with insurance companies to provide services and are reimbursed by insurance companies at a fixed rate. These contracted therapists are called "In-Network Providers". Insurance companies prefer that you use In-Network Providers. The contracted reimbursement rates are typically much lower than the rates most therapists charge for services. For example, most therapists charge about $125-$250 per session. Insurance companies will reimburse In-Network Providers typically in the range of $85 - $145 for a session, $95 is average including your co-pay or deductible.

 

Out-of-Network Providers: Many insurance companies will also reimburse you if you receive services from an Out-of-Network or Non-Contracted Provider. This reimbursement works differently as there is no contracted reimbursement rate. Insurance companies will typically reimburse either a set amount (for example, $45 per session, no matter the cost of the session) or a percentage of the session cost (for example, 50% of the amount billed). You are then responsible for paying the difference between what the therapist charges ($125 per session, for example), and what the insurance company reimburses (for example, 50%, or $65). For Hypnotherapy services, I require that you pay the full fee at the time of service and then I will give you a Superbill to submit to your insurance company for reimbursement (see below).

 

Some insurance companies will not reimburse Out-of-Network Providers at all in an effort to control their costs. In this case, you are responsible for the full session cost.

 

Monica Mayall is an Out-of-Network or Non-Contracted Provider for most national insurance companies (Anthem, Anthem Blue Cross, Blue Shield, Aetna, Magellan, Aetna, HMC, Kaiser, etc.) for psychotherapy and hypnotherapy services. Licensed Marriage and Family Therapists are allowed by insurance companies to create Superbills (payment statement with diagnosis) so the client can submit it to their insurance and request reimbursement.

 

Billing Insurance...
 

If you receive psychotherapy or hypnotherapy services from me as an Out-of-Network Provider I can provide you with what is called a Superbill. A Superbill is simply a receipt for the services you have received and paid for that has all of the information that an insurance company will need to consider reimbursing you for those services. You will need to contact your insurance company to find out how to submit a Superbill to request reimbursement. Procedures may differ by the insurance company.

 

Please notify me at your first session if you would like me to prepare Superbills for you. Typically, I complete Superbills on a monthly basis, but at your advance request, I can give them to you more frequently.

 

What You Need to Know...

 

You are responsible for understanding your insurance benefits and what will and will not be covered. Some questions you should ask your insurance provider before starting therapy are as follows:

  • Do I have mental health benefits?

  • Are my mental health benefits limited to certain mental illnesses or problems?

  • How much does my plan pay for a Licenced Marriage and Family therapist who is an Out-of-Network Provider?

  • What is my deductible for an Out-of-Network Provider and has it been met?

  • How many sessions per the calendar year does my plan cover?

  • Is a referral required from my primary care physician, psychologist or psychiatrist?

  • Is a “prior authorization code” or other approval required before I start therapy?

 

Other Important Information...
 

Insurance will not pay for missed or late-cancel sessions. In these cases, you will be responsible for the full session fee. A minimum of 24 hours notice of cancellation is required by text, email, or phone call.

 

If your insurance company requests a report in order to process your claim, you are responsible for payment for the report writing service. I will notify you of this requirement in advance of writing and billing for the report.

 

Questions?
 

If you have any questions about insurance or how billing works, please make sure to ask at your first appointment!

 

Sliding Scale Fees...
 

My goal is to provide sliding scale fees to as many clients with limited income as possible. To that end, I have a limited number of sliding scale appointments available for individual, couples, family, and group therapy. If you are unable to pay the standard fee please discuss this with me before our initial consultation/intake appointment. I will make every attempt to make therapy affordable for you. I accept cash, checks and credit cards.

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