Thalia's Thoughts:

Living in Peace and Harmony
with Others and Within Ourselves


Thalia's Fees and Insurance Participation
 

The fee for one session of therapy (45 to 50 minutes) is $90.00; initial session for assessment is $100.00. The fee is the same for individual, couple or family sessions.
 

Sliding Fee Scale -- If you do not have insurance and depending on your in-home family size and the household income (including  wages or salary from employment, child support, unemployment compensation, welfare grant, or other source of income for all adults living in the home), your out-of-pocket, adjusted fee may be less than the $90.00 fee. A Sliding Fee Scale is used to determine your fee to help make therapy affordable for you. You will never pay more out of your pocket than your adjusted fee for a session.
 

Using Insurance -- If you have insurance, the amount paid by the insurance company will apply to the $90.00 cost. You will pay your co-pay, as established by your insurance policy. If you have a deductible which must be met before the policy pays anything to the service provider, you will pay the $90.00 fee until the deductible is fulfilled. Your insurance company will be notified so the charges  are applied to your deductible properly.
 

 

If you should lose insurance coverage at some point, you will owe your full adjusted fee for any sessions not covered.

Using In-Network Insurance --  If Thalia is on the provider board for a specific insurance, and has agreed to accept their rates of pay, you may be charged less than the $90.00 fee. This may mean that the amount credited toward your deductible is less and that the amount paid per session before meeting the deductible is reduced. 

Currently, Thalia is on the provider boards of the following insurances, although other companies may also pay for her services on an out-of-network basis:


Aetna
Aetna EAP
Magellan Behavioral Health
Magellan EAP
PPOM/Cofinity
Health Plan of Michigan

APS Healthcare
CIGNA
Medicare

MultiPlan/Physicians Health Care Plan/PHCS
Blue Cross/Blue Shield Traditional
Blue Cross Blue Shield PPO
McLaren Health

State of Michigan Mental Health Case Management Program
Blue Care Network Advantage (Medicare)
Priority Health
Blue Care Network
Medicaid (Magellan, McLaren), Currently accepting children only, on a                                                             limited basis

 

It is ALWAYS the best policy for a client to telephone the Customer Service number on the back of the insurance card BEFORE the first session to confirm that Thalia is covered by your plan and what amount of coverage will be paid. You may have a deductible which you must pay on medical and/or counseling services before your insurance will start to pay anything. Some insurances require a pre-authorization for your treatment and will not pay unless you have approval from them FIRST.

Please
click this link to learn about how your medical information is utilized by insurance companies.

 

Insurance Billing -- The therapist will bill your insurance for you directly, if you give her the information to do so. Some insurances send the payment check to you instead of to Thalia. In these cases, you are expected to sign the check over to Thalia or to write your own check to cover this amount, in addition to any co-pays or deductible amounts. Failure to do this is fraud. Thalia does not bill secondary insurance but can provide you with a Superbill after the first insurance pays so that you may submit the claim yourself.

Legal Reports --
If reports (including oral, written, formal testimony, deposition, or appearance in response to subpoena even when not called to testify) for the legal / justice system are needed for your case, you will be charged for preparation, travel and report time at the rate of $100.00 per hour, with a minimum charge of $50.00 for a half hour or portion thereof.  The sliding fee schedule does not apply to these services. Most insurance will not cover sessions or reports for court required or utilized services.

 

 



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