Fee Information, Insurance Questions &
Good Faith Estimate under "No Surprises" Act

Fees and scheduling availability for therapy services are important logistics to evaluate when making your decision to begin the therapy process. Balanceworks Counseling Services will do our best to work with your availability. Our clinicians offer early morning, evening, and weekend appointments so that you can take care of yourself despite your busy schedule.  

 

While therapy is an investment in yourself, (one that we believe at Balanceworks is well worth it for everyone!) it is not always possible to financially prioritize it based on what is going on in our lives.  Some clients choose to use their insurance benefits to help defray the costs of therapy.

 

It is important to know that we are not in network with insurance companies and cannot bill them directly to cover services provided to you.  However, many of our clients use their out of network insurance benefits to help pay for therapy and nutrition counseling services.  If your insurance plan offers out-of-network benefits, you should receive some reimbursement for therapeutic services.  We will provide you with a superbill that will include all of the information you need to submit your claim in order to get reimbursement.

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 one 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.

 

Here are questions that are helpful to ask your insurance company before our first appointment:

  • Do I need prior authorization in order to have my therapy sessions covered by my insurance plan?

  • What are my mental health benefits?

  • Do I have out-of-network coverage for my mental healthcare? How much does my plan cover for out-of-network provider fees per session?

  • How many sessions does my plan cover per year?

  • Do I need a referral from my primary care physician?

  • What is my deductible? What is the calendar year for my deductible?

If you have questions, or if we can help with what can be a confusing process, please ask! We are happy to help you navigate!