FEES AND INSURANCE

Our Wisconsin-licensed providers are currently in-network with a limited number of insurance companies. We continue to apply for contracts to expand on these. We can verify benefits before your first session. We will submit insurance claims on your behalf.

In network:

  • Blue Cross Blue Shield in the following counties of Wisconsin:

    • Buffalo

    • Burnett

    • Douglas

    • La Crosse

    • Pepin

    • Pierce

    • Polk

    • Saint Croix

    • Trempealeau

    • Vernon

  • Healthpartners

  • Optum (United HealthCare, Medica, UMR)

  • Optum EAP

  • Compsych EAP

  • BHS EAP

Out of Network:

Most insurance plans have out-of-network benefits with an out-of-network deductible.  We will submit insurance claims on your behalf which notifies the insurance company of fees you have paid towards your out-of-network deductible.  Once your deductible amount is met, out-of-network benefits will then kick in, and they commonly pay a reduced portion of the claim amount.  

Good Faith Estimate

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. 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 651-756-7590.

Advantages of Private Pay for Counseling

Some clients opt to pay for their counseling out of their pocket.  This is sometimes referred to as "private pay".  Each provider will negotiate a reduced fee private pay agreement for those clients that wish to pay for services without going through their insurance.  

Insurance companies require a diagnosis before they will reimburse for medical services, including counseling.  Private pay clients do not need to have a diagnosis made or documented.  Some clients are concerned of having the "label" of a certain diagnosis, and there are reports that certain mental health diagnoses can impact the application process for disability insurance, life insurance, and long-term care insurance. 

Many excellent therapists have applied to insurance companies to become in-network with them and have been declined, despite having excellent credentials and experience.  Many insurance companies limit the number of providers by geographic area.  Private pay clients can see whoever they feel is a good match for them without any interference from insurance companies.  

If you have a Health Savings Account (HSA), any fees paid to a licensed provider can be submitted to your HSA for reimbursement. 

INSURANCE AND ONLINE COUNSELING

Online mental health services (telemedicine) are covered by your health insurance. For all services, a reduced fee, private pay arrangement can be made.  Fees for in-office and online services can be submitted to an HSA account for reimbursement.