Private Pay & OON Provider

Private Pay and OON (Out-Of-Network) Provider

Integrative therapy is offered as a private pay and out-of-network service. I am not in-network with any insurance plans. This page outlines exactly what that means. 

Why Private Pay?

Private pay therapy allows for a more individualized and flexible approach to care. It creates space for therapy to be guided by your goals, your pace, and your whole-person experience, rather than being shaped primarily by insurance requirements.

For many of my clients, private pay therapy offers greater privacy, more choice, and greater flexibility in the therapeutic process. It can also allow us to focus on the deeper, more nuanced work that may not always fit neatly into a traditional insurance model.

Private Pay Rates

$200 for a 60-minute session for new clients (returning clients, please contact me as your rate will be closer to the previous rate you were at)
$300 for a 90-minute session for new clients (returning clients, please contact me as your rate will be closer to the previous rate you were at)

For EMDR Intensives those are designed uniquely every time and pricing varies 

Private pay is not for everyone. I strongly recommend not utilizing a private pay provider if it will be a financial burden. Financial stress does not help mental health. 

I also strongly recommend not utilizing a private pay provider if you find it irritating to not use your insurance. If you really want to use your insurance and get annoyed every time you have to pay for therapy out of pocket, it may limit the beneficial impact therapeutic sessions can have. The therapeutic alliance is very important to the healing process and if private pay therapists bother you, I would recommend searching for an in-network therapist in your insurance plan that is a good fit. 

People who use private pay usually prefer so for the reasons listed above along with sometimes not wanting a mental health diagnosis. Sometimes a mental health diagnosis can impact employment, getting life insurance, or can negatively impact life in other ways. Sometimes they just want to keep things extra confidential. 

Out-Of-Network Benefits And Utilizing Thrizer To Make The Process Easier And Having The Option To Pay Less Up Front

Check Your Out-Of-Network Benefits

Many clients are surprised to learn that they may be able to use out-of-network benefits toward therapy. I partner with Thrizer to make this process clearer and easier, so you can estimate your possible reimbursement and better understand what your sessions may cost before getting started.

What Thrizer Does In Simple Words 

• Automatically submits claims on your behalf with your insurance (When you pay on the Thrizer platform, a claim is automatically submitted)
• Let’s you choose how you pay 

1. Pay your co-insurance only 
2. Pay in full and wait for reimbursement

• Charges a small, transparent fee for handling the paperwork (Only when they do the work)

Thrizer Therapy Payment Platform – Automatic and Easy

• Claims are submitted every time you pay
• Pre-deductible: $0 fee. 
• Out-of-Network Pay (post-deductible): You pay $200 (my rate); Thrizer submits the claim and you get reimbursed quickly. Fee is 1% of the rate and only if reimbursement is successful.  Or….
• Thrizer Therapy Pay: You pay your co-insurance at each session and Thrizer fronts the rest. Fee is 5% of my rate. Thrizer has a strict no back charges policy if a claim is denied or has a lower reimbursement rate than expected. Basically, Thrizer isn’t going to come after you for money at a later date 😊 

What Happens If I Don’t Want To Use Thrizer For My Out-of-Network Benefits? 

I can provide you with a superbill which you can submit directly to your insurance company (Thrizer also has an option where you can submit a superbill through them and there is a small fee). 

A superbill is a detailed receipt. It includes the session date, provider credentials, diagnosis code, and procedure code (CPT), the information insurance companies need to consider your reimbursement claim. 

If you have questions about private pay, out-of-network benefits, or using Thrizer, and are interested in starting therapy with me, please book a phone consult.  We can discuss why you are interested in therapy and questions about the different ways to pay for therapy. 

Understanding Your Right To An Estimate Of Expected Charges

Under the federal No Surprises Act, individuals who do not have health insurance or who choose not to use insurance to pay for their care have the right to receive a written Good Faith Estimate of the expected cost of non-emergency healthcare services, including psychotherapy.

When Will I Receive A Good Faith Estimate?

Timing depends on when services are scheduled and when the estimate is requested: (A Good Faith Estimate must be requested; it is not automatically provided). 

• If a service is scheduled between 3 and 9 business days in advance, the Good Faith Estimate will be provided no later than 1 business day after scheduling.
• If a service is scheduled 10 or more business days in advance, the Good Faith Estimate will be provided no later than 3 business days after scheduling.
• If a Good Faith Estimate is requested before services are scheduled, it will be provided no later than 3 business days after the request.

The Good Faith Estimate will be provided in writing in a format that can be saved and printed. It will describe the services and charges that are reasonably expected based on the information available when the estimate is prepared.

A Good Faith Estimate is not a bill or a contract. The services needed, frequency of appointments, and total charges may change as treatment progresses. Receiving an estimate does not require someone to receive services from Connecticut Integrative Counseling, LLC. 

If the amount billed by a provider is at least $400 more than the amount listed on the Good Faith Estimate, the client may be eligible to use the federal Patient-Provider Dispute Resolution process. Beginning this process will not negatively affect the quality of care provided.

Clients should save a copy of their Good Faith Estimate. To request one, please contact Connecticut Integrative Counseling at (860) 920-7070 or suzi@ctintegrativecounseling.com

For more information about Good Faith Estimates and the No Surprises Act, please visit:
https://www.cms.gov/medical-bill-rights 
https://www.cms.gov/nosurprises
Phone number: 1 (800) 985-3059