Using Insurance Benefits for Counseling
Aspire Counseling is Out of Network
At this time, Aspire Counseling therapists do not work directly with insurance companies (see below for details about why).
Depending on your current health insurance provider or employee benefit plan, it is possible for services to be covered in full or in part, and many of our clients do get reimbursed. Please contact your insurance provider directly to verify how your plan compensates for Out of Network psychotherapy services. Some of our clients have reported have nearly all of their services covered while others have had very little covered by insurance. We always recommend calling before your first appointment so there are no surprises down the road.
Questions to ask Your Insurance Company:
- Does my health insurance plan include out of network mental health benefits?
- Do I have a deductible? If so, what is it?
- Do I need preauthorization to be reimbursed for out of network mental health services? If so, what is that process for obtaining preauthorization?
- What percentage or amount of my care will be covered after I’ve met the deductible?
- Are specific diagnoses required for me to be reimbursed?
- Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
- Do I need written approval from my primary care physician in order for services to be covered?
- What credentials does a provider need to have in order to be reimbursed? (Jessica & Stephenie have LCSWs, Joni is an LPC and Ben is a Counselor in Training supervised by a licensed psychologist)
- What percentage of my out of network mental health services will be covered if I submit a Superbill? Is there anything else I will need to submit with the Superbill?
- How do I get reimbursed for out of network mental health services? How often should I submit a Superbill, what is the process for submitting that and how long will it take for me to be reimbursed?
***After gathering this information, ask for a confirmation number and the name of the person giving you this information.***
Can I use my insurance benefits?
We are happy to provide you with a Superbill to submit to your insurance if your plan includes reimbursement for Out of Network psychotherapy services. A Superbill is essentially a receipt stating how much you were charged and what you’ve paid for therapy but it has some extra information that the Insurance will want such as your therapist’s license information, our address, and the “CPT code” that tells the insurance what type of service you received. We do not know if your insurance company will reimburse you or not. If you would like to use your insurance benefits, we strongly recommend you call your insurance company directly prior to your first appointment to ask about your out of network benefits for mental health services.
Each of our therapists sets their own rates based on their training, experience and specialty. Many of our therapists offer a free phone or in person consultation. The first appointment is typically longer (90 minutes) and will be focused on your therapist getting to know you (assessment) and helping you set goals for your treatment. Please call or e-mail for additional information about an individual therapist’s rates.
Jennie’s current rate: $120 per 45 minute counseling session or $135 for 60 minutes
Ben‘s current rate: $90 per 45 minute counseling session
Stephenie’s current rates: $110 per 45 minute counseling session or $120 for 60 minutes
Joni Perry’s current rates: $100 for standard 45 minute counseling session
Jessica’s current rates: Call for current rates and/or openings.
Why don’t we bill insurance directly?
At Aspire Counseling, we believe that you should be able to grow and change in a safe environment. At the core, counseling can be a vulnerable experience. That’s why we fiercely protect our client’s confidentiality and goals for growth. Since we opened our Columbia, MO office in 2017, we have never directly billed insurance. This may seem odd, but since a core value of ours is confidentiality and doing what’s in the best interest of our clients, we continue this. Here are a few reasons we do it:
Reason #1 Why We Don’t Take Insurance | It’s Not Confidential
Insurance companies require us to use an Electronic Medical Records system if we take insurance. Last year alone, the Department of Health and Human Services recorded 24,000 HIPAA violations. Over time we disclose information to a 3rd party insurance or technology company, there is increased risk to your information being out there. As well, if you or your child eventually needs a federal background check, wants to be a pilot, or a variety of other reasons, a diagnosis can be disclosed through your insurance company. We want you to feel safe to open up in your therapy sessions knowing that what you say int he office will stay between you and your therapist.
Reason #2 Why We Don’t Take Insurance | You Have to Be Diagnosed
In order to have insurance cover counseling, we have to diagnose you. Even if it’s not appropriate, there has to be a diagnosis. For example, if a couple comes in for counseling, for it to be covered, one person has to have a label. Similar to reason one, we don’t think you should have a mental health diagnosis on your permanent medical record. To us, everyone should have access to counseling. We can all use a little help! We want you to get help without having to have a diagnosis!
Reason #3 Why We Don’t Take Insurance | Our Time is Focused on You
All of the paperwork associated with using insurance companies takes up a great deal of time. Each insurance company has it’s own (very long) set of paperwork that a therapist must fill out to be included and then the process of billing the insurance, sending them documentation, etc. takes up even more time. The time that we save at Aspire Counseling by not worrying about that paperwork we can instead spend focusing on giving you the best possible care whether that means reading up on the latest research, making phone calls on your behalf or responding to your e-mails. Our focus is on meeting the needs of our clients-not granting the requests of an insurance company.
Reason #4 Why We Don’t Take Insurance | They Decide Your Treatment
Insurance companies decide treatment. They determine the number of sessions and the frequency. We believe this should be you and your therapist’s choice. Sometimes you need shorter sessions or longer ones. Maybe you need them 2x per week or once per month. When an insurance company is involved, they can dictate what they are willing to pay for so in effect someone who has never met you before is deciding whether or not they feel you need a specific treatment. Our clients enjoy the freedom to choose what is best for their mental health along with their therapist. When a client calls needing an emergency extra appointment even though they’ve already been in that week, we can make an appointment without worrying if insurance will cover it. If you need 60 minute appointments instead of the standard 45 minutes, you talk to your therapist and make it work. If someone’s participating in Prolonged Exposure for PTSD, we can follow the evidence based practice of offering you a 90 minute session.
At Aspire, you and your counselor base your treatment on what you need-not what someone sitting in an office in another state feels like you should need. We’re able to make any adjustments to your treatment quickly if something in your life change. For instance, if you are coming for anxiety but suddenly lose a family member we can adjust our work to focus on the grief. We want you to get the best quality of counseling treatment!
We accept cash, check, Health Savings Account cards and all major credit cards as forms of payment. Checks can be made payable to Aspire Counseling. Payment is expected at the time of service.
If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. You will be charged for the full rate of the session if you cancel with less than 24 hours notice. All no show appointments will be charged the full rate of the session.
We understand that life happens and there are times when you simply cannot make an appointment. However, a cancelled appointment hurts three people: you, your therapist, and another client who could have potentially used your time slot. When a session is cancelled without much notice, we are unable to fill this time slot by offering it to another client.
Please contact us with any additional questions you may have. We look forward to hearing from you!