WHY WE DO NOT ACCEPT HEALTH INSURANCE
We don’t believe that all people fit in one box, and we see the individual rather than the label. We also believe that the most effective care includes tailoring each treatment plan to meet the unique needs of the individual - not meet the rigid guidelines of the insurance company. We utilize highly effective modalities such as customized intensives, workshops, and experiential therapy to support our clients in getting faster relief from pain, and these are not recognized by health insurance.
All insurance claims require a diagnosis of a mental health disorder to be considered for payment or reimbursement. While there are certain diagnosable mental health issues that we treat, there are often reasons that people seek therapy that do not require a diagnosis. Examples can include emotional pain stemming from a separation or divorce or coping with the demands of a high-pressure job.
When submitting information to an insurance company, the insurance company - not you - decides how many sessions are appropriate for your treatment and the length of those sessions. Private information shared with your insurance company may be stored in the Medical Information Bureau where it can be accessed in the future by other parties such as life insurance companies.
Some insurance plans offer “out of network” insurance coverage. The way this works is you pay for therapy with any out of network provider that you choose and then submit a detailed receipt called a Superbill directly to your insurance company to request reimbursement. We do provide this Superbill for use at your discretion. Please be aware that this still carries a certain amount of risk because you are submitting information about your clinical care. Most insurance plans will request that a diagnosis be included on this Superbill, and not all therapeutic issues are reimbursable. It is your responsibility to communicate with your insurance carrier regarding any out of network coverage you may have and the specifics of that coverage. It is for all of these reasons that Blue Sage Counseling and Wellness does not accept insurance. Thank you for understanding.
GOOD FAITH ESTIMATE
This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created, and does not include any unknown or unexpected costs that may arise during treatment.
IF YOU HAVE ANY QUESTIONS ABOUT YOUR BILL, YOU CAN REACH OUT TO US AT ANY TIME.
Throughout your treatment, the provider may recommend additional items or services as part of your treatment that are not reflected in this estimate. These would need to be scheduled separately with your consent and the understanding that any additional service costs are in addition to the Good Faith Estimate.
If your needs change during treatment, your provider should supply a new, updated Good Faith Estimate to reflect the changes to treatment, and the accompanying cost changes.
You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, ask to negotiate the bill, or ask if there is financial assistance available.
The Good Faith Estimate is not a contract between provider and client and does not obligate or require the client to obtain any of the listed services from the provider.
You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about 4 months) of the date on the original bill.
There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount.
To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call HHS at (800) 985-3059.
For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call (800) 985-3059.
Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount.