Fees

I currently accept Blue Cross Blue Shield PPO, Aetna PPO, Medicare, out of network coverage from other PPOs, and direct payment (cash, credit, check).  My sessions are 50 minutes each.

If You Have Insurance

How it usually works

If you have insurance, then your insurance company determines how much I can charge.  This is called the “usual and customary” fee.  The insurance company then pays a certain percentage of that amount (depending on your plan), and you pay the rest.  However, depending on your plan, you may also have a deductible that you have to pay each year before insurance coverage kicks in, and/or you may have a session limit.

For example: Blue Cross Blue Shield allows me to charge $88.20 per individual session.  Now let’s say that they cover your services at a rate of 80%, then they would pay $70.56 and you would pay $17.64 per session.

However, if you also had a $600 deductible, then you would have to pay the usual and customary fee ($88.20) per session until you reach $600, after which your coverage would kick in, and you would start paying $17.64 per session.

Call your insurance company before receiving services

It is important that you call your insurance company before receiving services.  Tell them that you are seeking outpatient mental health services, and ask them these questions:

1. “Do I need pre-authorization?”  (If so, ask them how to do this.)
2. “Do I have to pay a deductible?”  (If so, ask them how much you will need to pay before coverage kicks in.)
3. “Do I have to pay co-insurance or a co-pay; and what would that amount be?”  (This is what you would pay out of pocket for each session.)
4. “Do I have a session limit?”  (If you go past your session limit for the year, the additional sessions would be charged to you at full fee (see below).  If you have had previous mental health services this year, your session limit may include those as well, so make sure you know how many you still have left.)
5. You might also want to make sure that they don’t sub-contract mental health coverage out to another company.

I recommend that you talk to your insurance company before your first session, so that you can be sure what to expect.  Your insurance company may require you to do so, so that you can get pre-authorized.

Hoover & Associates also verifies your insurance.

Hoover & Associates will routinely contact your insurance company before your first appointment.  We will let you know what your insurance company told us.

If You Do Not Have Insurance

Usually, if you do not have insurance (or prefer not to use it), then you would be expected to pay full fee.  Hoover & Associates has set their fee at $165 for a 45-50 minute individual talk therapy session.  Depending on the service being provided, the fees vary:  an initial evaluation is $210, a group session is $85, and  a couples session or family session is $185. For clients who do not use insurance, payment in full is expected at each session.

If you have any questions regarding fees or payment, please feel free to call me at 708-429-6999, ext. 229

Anda Jines MS LCPC offers mental health counseling services in the southwest suburbs of Chicago, in Tinley Park, IL (60477); near Orland Park, Oak Forest, Orland Hills, Palos Heights, Mokena, and Frankfort. Click here for more about Anda Jines MS LCPC. Click here for more about Hoover & Associates.