Story: Many years ago and far away, Jerry was asked to help determine a treatment plan for a 10-year old boy. This boy had been in individual therapy for over 2 years, was in a day treatment program for 3 hours out of each school day, and had a county mental health case manager. All good people, all doing a good job. But no one could figure out how to help this child. After Jerry had spent some time gathering history from the boy, his mother, and the county social worker a pattern was showing. Jerry asked, "Has he been exposed to any harsh treatment?" (This is a gentle way of asking if he has been abused--all the signs were pointing to it.) Mom and social worker were adamant that it was very unlikely...but the boy said "Mom, you don't know what dad's like when you"re not around!" He then detailed a number of repeatedly abusive incidents. Mom was in tears, social worker shocked, and the boy was finally able to get the help he needed.
Not all situations are as dramatic as that, but you can see that spending $194 and finding the right intervention far outweighed the $1000's spent over the previous 2 years with very little results.
You need to contact your health plan managers to determine how to submit claims for payment of out-of-network services. You will need to be persistent because some health insurance plans very actively discourage you from seeing out-of-network providers. See difficulties with "managed care" for reasons why. See 3 Steps to Get Health Insurance Reimbursement for how easy it is for many to submit claims.
Many people use health insurance benefits to help pay for medically necessary mental health services. You have a contract with your health insurance company for specific benefits. Sometimes those benefits are not adequate to provide all needed or recommended mental health services. You must determine if you wish to follow our recommendation even though your health insurance company will not pay for those services. In rare cases, we may discontinue services if you do not comply with treatment recommendations.
Story: Insurance companies typically pay for one diagnostic / assessment session. I have developed a protocol for assessing ADHD. This protocol includes the guidelines and recommendations from prominent organizations such as the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the leading journals and textbooks in the field, and many other sources. If one would properly diagnose ADHD it would take closer to 12 hours than one - yet it is standard practice for insurance companies to pay for one.
Sessions are $194 for a 45 - 50 minute session. I do see some clients for reduced fees or pro bono -- usually based on a referral from your pastor.
I am a psychologist because I want to help people -- but I also make my living doing this. I am extremely sorry that I can no longer offer payment plans. Unfortunately too many clients abused that.
Missed appointments (or late cancelled appointments) are billed at the normal rate.
Parent Category: Counseling
Relationships for Life
Healthy Brains for All Ages
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