Insurance, Fees, & Payment Information

Fostering Greatness is not in-network with any insurance carriers, which means insurance is not accepted for therapy and you are responsible for the full session fee at the time of scheduling your appointment.

Some insurance policies have out of network benefits and if you have those and wish to use them to reimburse you a portion of the session fee, to offset the cost of therapy to you out of pocket, you can request a “superbill,” which Fostering Greatness will provide to you. A superbill is a receipt the insurance company requires for you to submit for your out of network reimbursement. Fostering Greatness provides superbills on a monthly basis, for sessions attended the month prior. It is important to note that in order to provide you with a superbill, Fostering Greatness is required by your insurance company to give you a psychiatric diagnosis to prove “medical necessity” for your therapy sessions.

Fostering Greatness is not in-network with insurance for a number of reasons. Most importantly, insurance companies often like to dictate the type of treatment you are able to receive and/or the amount of sessions you are able to have per year. At Fostering Greatness it’s recognized that therapy must be individualized for each client and true healing and change doesn’t work like that – in predetermined formats. Instead, you are a part of the treatment process determining how often you’re seen for therapy and in what format, tailoring the treatment to you and what will be most effective for you.

 

15 minute phone consultations, to ensure Rena is the right fit for you as your therapist, are free! Please complete this brief questionnaire to request a consultation.

 

Therapy Session Fees

Psychotherapy session fees range from $170 – $315, depending on the therapeutic service you are seeking. Below are the session fees according to the type of session you are seeking:

Psychotherapy:

Intake Session (45 Minutes): $190

Individual Therapy Session (45 Minutes): $170

Couples Therapy Session (45 minutes): $190

Parenting Education Session (45 Minutes): $170

Parent-Child Therapy Session (45 Minutes): $190

Ketamine Assisted Psychotherapy:

Fostering Greatness partners with the medical team at Initia Nova in order to jointly provide KAP to our clients. The medical portion of KAP appointments are billed separately through Initia Nova (click to visit their website).

KAP Treatment Series (This fee covers the treatment series that is recommended – 3 Prep sessions/8 KAP sessions): $2,570

– Clients can opt to pay for KAP sessions as they are scheduled and the session fees would be as follows:

    • Intake Session/Preparation Session One (45 Minutes): $190
    • Preparation for KAP Session [sessions 2 & 3 of three sessions total] (45 Minutes): $170/session
    • Ketamine-Assisted Psychotherapy (KAP) session (1-1.5 hours): $320/session

KAP sessions following your initial series (also referred to as “maintenance sessions”): $265

 

15 minute phone consultations, to ensure Rena is the right fit for you as your therapist, are free! Please complete this brief questionnaire to request a consultation.

 

How Fostering Greatness Manages Billing

Fostering Greatness utilizes a confidential, online client portal for clients where all intake documentation is completed electronically, all therapeutic resources are shared, billing documents and receipts are available, and payment is collected. The client portal also keeps track of all appointments, past and future, and will send you appointment reminders via email and/or text message, unless you opt out. All clients are required to have a credit card on file in their client portal and session fees are due upon scheduling to hold your appointment spot. If you opt to receive ‘superbills’ those are available on the first of every month, on the client portal, which are able to be downloaded and/or printed.

 

More on Out of Network Benefits

Utilizing your out of network benefits, should you have them, means that after paying Fostering Greatness upfront for the cost of your therapy session, you then submit the superbill to your insurance company (typically through your member portal online) and your insurance company will then reimburse you a portion of the session fee you paid, per your plans terms. Typically a deductible and/or coinsurance does apply and therefore this can impact your reimbursement.

The best way to verify if you have out of network benefits is to call the number on the back of your insurance card and speak to your insurance carrier.

Important questions to ask your insurance carrier when you call:

  1. Do I have out of network benefits for outpatient mental health services?

Your insurance company may ask you what the “service code” is. If they do, you can give them the following codes that apply to the therapy you are seeking:

90791: Intake Session

90834: Individual Therapy Session; Preparatory Session for KAP

90837: Ketamine-Assisted Psychotherapy (KAP) Session

90847: Parent-Child Session or Couples Session

90846: Parenting Session or Couples Session with only one member present

90832: This code is used when the session time is under 38 minutes & therefore this code will only be used if you arrive late to your session or for any other reason the session time is below that threshold.

  1. Are telehealth services through HIPAA compliant platforms eligible for reimbursement?
  1. What is my deductible? Do I have coinsurance that will apply?

[A deductible is the set amount you pay, per year, for medical services and prescriptions before your health plan begins to share in the cost. Coinsurance is the portion of costs you pay after you’ve met your deductible].

If you are on an insurance plan with other members of your family you will want to specifically ask if there is a separate individual and family deductible. This will impact whether your family members’ usage of your insurance counts towards your deductible or not, which will impact how soon the insurance company will begin reimbursing you if you have a deductible.

You can ask whether your deductible has been met already or where it currently stands.

  1. What percentage of the therapy session fee is reimbursed after the deductible is met? Is this percentage calculated from the fee the therapist charges me or a “usual and customary” rate?

A ‘usual and customary’ (UCR) rate is a dollar amount your insurance company has determined is the appropriate amount for the service (in this case therapy) based on the geographic area and what they determine the providers in the area usually charge. This rate is often difficult to obtain from insurance companies, as they prefer to keep this number secret. However, it is important to know if your insurance company uses a UCR as this may change the amount you are reimbursed. For example, if your insurance company says they will reimburse you 50% after your deductible is met, you will want to know if that is 50% of what you were charged for your therapy session or 50% of the UCR rate they have decided.

  1. How do I submit a claim for my out of network benefit?

 

Please note that I cannot guarantee reimbursement from your insurance company.

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You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.

Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.