Client Responsibility for Payment
- Adult patients are legally responsible for the timely payment for services received from their psychotherapist(s) at Hoover & Associates. If using insurance, payments are due after claims have been processed by the insurance company. If paying cash, payments are due at the time of service.
- The parent/guardian who brings a minor child in for treatment is responsible for the bill. In other words, they are responsible to pay the balance for the minor child they brought in for services, rather than expecting the other parent, or anyone else, to pay the balance. If using insurance, payments are due after claims have been processed by the insurance company. If paying cash, payments are due at the time of service.
- If the patient is a dependent adult, another responsible party must guarantee payment, as in the case of a minor child.
- The word “client” below refers to the party responsible for the payment.
- Some samples of Hoover & Associates’ full fees (before adjustment) are listed below. Clients may ask the business office or their therapist about prices for any other services or other session lengths. These fees are per 45 minutes unless indicated otherwise.
- First Session (intake evaluation) $210
- Individual Session (45minutes) $165
- Individual Session (60 minutes) $200
- Couples or Family Session $200
- Psychological Testing (Psy) $195
- Psychological Testing (Tech) $110
- Neuropsychological Testing (Psy) $195
- Neuropsychological Testing (Tech) $110
- Missed appointment fees are charged when appointments are missed with no cancellation call, and when appointments are cancelled less than 24 hours ahead of time. Missed appointment fees may be up to the full fee for the missed session. Clients can ask their therapist for further details about how the therapist usually handles this. Insurance does not pay for missed appointment fees.
- Phone sessions: Insurance does not pay for phone therapy. Therefore any phone therapy, if provided, would be the client’s responsibility. Phone sessions cost $35 for 5-10 minutes, $70 for 11-20 minutes, and $105 for 21-30 minutes.
- Payment Options:
- Payments can be made directly to the therapist, to business office staff, or by phone, or by mail.
- Hoover & Associates accepts cash, checks, money orders, and debit or credit cards, including: Visa, MasterCard, Discover, and American Express. Automatic payments can be arranged when using a credit card.
- Most Hoover & Associates clinicians are in-network with Blue Cross Blue Shield PPO and Aetna PPO. Some are also in-network with Cigna PPO, Medicare, Southland IPA, and Compsych. (see D1 below)
- We can accept reimbursement from other insurance companies as well, at out of network rates (see D2 below).
- Some therapists also accept sliding scale fees through the Family Education Center.
- Please see the clinicians’ website profiles for more information about the forms of payment each one accepts, and insurance companies with which each is paneled.
- Timely Payments: Clients make payments on the date of service (once amount of co-pay is known), or within 30 days of receiving a bill from Hoover & Associates, unless special arrangements have been made (see section G below).
If Using Insurance
- In Network: The client’s insurance company sets a “usual and customary” dollar amount which they allow in-network providers (therapists) to receive for each type of service.
- Insurance then pays a certain percentage of that “usual and customary” amount (depending on the policy), and the client pays the remaining percentage “coinsurance”. Or the insurance company sets a “copay” which is not a percentage but a dollar amount (such as $25 per session).
- Hoover & Associates adjusts their fees down to the “usual and customary” amount set by insurance companies with whom we are “in network”. This is reflected on statements as an “adjustment.”
- The “usual and customary” rates allowed by the insurance company are subject to change and are not guaranteed until the claim is processed. Therefore it is impossible to guarantee the exact price of each session (or the exact amount of the coinsurance) until after the insurance has processed the first couple of sessions.
- The client can wait until their insurance company has processed their claim before they start paying coinsurance (if any).
- Clients are required to pay their copay (if any) at the time of each visit.
- Out of Network: If the client’s therapist is out of their insurance company’s network, then:
- The client is responsible to pay the difference between the session fee and the amount their insurance pays.
- The insurance policy determines the client’s “out of network” coverage, which may be less than my coverage if they had chosen an “in-network” therapist.
- The client pays the portion they owe (their copay, coinsurance, and/or deductible) either on the date of service (if amount is known) or when billed by Hoover & Associates.
- The client is responsible for the timely payment of any services received and not covered by their insurance, as allowed by contractual agreement or law. This includes missed appointment fees and phone therapy fees.
- Hoover & Associates strongly recommends that the client confirm their benefits before treatment to avoid difficulties. It is the client’s responsibility to know their insurance plan, including, but not limited to:
- Whether their policy covers outpatient mental health services.
- Whether their policy requires pre-authorization and re-authorization.
- Whether they have to pay a yearly deductible, and how much they currently owe on it.
- What percentage of the “usual and customary charge” their insurance will cover, and what percentage they have to pay (their coinsurance/co-pay).
- Whether their insurance policy has a limit on the number of outpatient mental health sessions per year (or per lifetime), and whether they’re close to it.
- Whether their insurance policy has a limit on the dollar amount paid out annually (or over a lifetime), and whether they’re close to it.
- If the client needs help understanding their insurance plan, they can discuss this with their therapist or with the business office staff at Hoover & Associates. (We’re happy to help.)
- Hoover & Associates files insurance claims on a daily basis. If the client chooses to file their own insurance claim, they must pay in full at each session, and they must request that a diagnosis be indicated on their receipt.
- A diagnosis will be required by the insurance company, and some diagnoses are not covered by insurance, resulting in claim denial. The client has a right to discuss their (or their dependent’s) diagnosis with the treating professional.
- Hoover & Associates uses “remainder statements” showing only the amount due after insurance has paid. Therefore bills will not show previously paid charges or charges still pending with insurance.
If NOT Using Insurance
If the client is paying directly for services received at Hoover & Associates, payment in full is due at the time of each service.
Sliding Scale Fees
Hoover & Associates is affiliated with The Family Education Center – a non-profit organization that provides sliding scale rates for psychotherapy and psychological testing, for individuals and families without insurance. These services are provided at the Hoover & Associates office.
We know that many families have lost their health insurance in the current economic situation. We want to help those families access therapy when they need it. Cost is based on the number of dependents and the annual gross family income. If you’d like to inquire about sliding scale services, call 708-429-6999 and ask for “sliding scale services”.
Read more about the story behind the Family Education Center.
The Family Education Center can also arrange for a licensed mental health professional to speak to your group about a mental health topic.
- Again, if the client does not have insurance coverage, and if they can’t afford the full fee, then sliding scale fees may be available through the Family Education Center. (See above)
- If the client is struggling to pay their bill, it is their responsibility to discuss this with their psychotherapist. If appropriate, a written and signed individualized payment plan or special fee agreement may be designed. Individualized payment plans and special fee agreements are granted only under special circumstances and are at the discretion of the psychotherapist.
- A therapist may choose to require special conditions with regards to billing and payment for a particular client, in circumstances which warrant it, such as a history of failure to pay in a timely manner.
Failure to Pay
- Hoover & Associates will add a 1% interest charge on balances that are over 60 days past due.
- There will be a $25 fee for any returned checks.
- If bills sent by Hoover & Associates are not paid by the 3rd bill (after 90 days), the client’s outstanding bill may be sent to collections. If this happens, the client is responsible for any collection fees and any other costs associated with the collections process. Once an account has been listed with the collection agency, payments must be made directly to the collection agency. Our office cannot accept collection payments.
- A therapist may decline further services to clients who have a history of failure to pay.
Questions regarding insurance or billing can be left on the voicemail of Carrie in the business office at (708) 429-6999, extension 228. Please note that the business office is not staffed by full time employees. Although we try to return calls within one business day, returning a call may sometimes take two to three business days. For an urgent business matter, please contact your treating psychotherapist.