Frequently Asked Questions

One of the biggest reasons people default to using insurance to pay for a therapist is because, often, it is a service in which they have already invested, which provides them access to therapeutic services. But, there are also benefits to why some people pay out of pocket or self-pay for therapy. 

Here are some brief examples: 

  • Your privacy is protected without sharing it with the insurance company.
  • You have total control of choosing a therapist you want, ensuring they match most if not all of your needs
  • You, along with your therapist, have more control over the kind of treatment  modalities used, the duration and frequency of your sessions
  • You have more control over the process and narrative of your journey.

Under the No Surprises Act (H.R. 133 – effective January 1, 2022), health care providers need to give clients or patients who do not have insurance or who are not using insurance an estimate of the bill for medical items and services.

This Good Faith Estimate shows the costs of items and services that are reasonably expected for your health care needs for an item or service. The estimate is based on information known at the time the estimate was created. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes (under the law/when applicable) related costs like medical tests, prescription drugs, equipment, and hospital fees.

The Good Faith Estimate does not include any unknown or unexpected costs that may arise during treatment. You could be charged more if complications or special circumstances occur. If this happens, federal law allows you to dispute (appeal) the bill. 

If you receive a bill at least $400 more than your Good Faith Estimate, you can dispute the bill.

  • You may contact the health care provider or facility listed to let them know the billed charges are higher than the Good Faith Estimate. You can ask them to update the bill to match the Good Faith Estimate, negotiate the bill or ask if there is financial assistance available. 
  • You may also start a dispute resolution process with the U.S. Department of Health and Human Services (HHS). If you choose to use the dispute resolution process, you must start the dispute process within 120 calendar days (about four months) of the date on the original bill. 
  • There is a $25 fee to use the dispute process. If the agency reviewing your dispute agrees with you, you will have to pay the price on this Good Faith Estimate. If the agency disagrees with you and agrees with the health care provider or facility, you will have to pay the higher amount. 

Make sure your health care provider gives you a Good Faith Estimate within the following timeframes:

  • If the service is scheduled at least three business days before the appointment date, no later than one business day after the date of scheduling;
  • If the service is scheduled at least 10 business days before the appointment date, no later than three business days after the date of schedule; or
  • If the uninsured or self-pay patient requests a good faith estimate (without scheduling the service), no later than three business days after the date of the request. A new good faith estimate must be provided within the specified timeframes if the patient reschedules the requested item or service.

The No Surprises Act has a universal waiver form required — which Spoken Balance has adapted into an identical online form. You may view the PDF of the waiver here. 

This is the public disclosure of the “Good Faith Estimate.”

Note: A Good Faith Estimate is for your awareness only. It does NOT involve you needing to make any type of commitment. To learn more and get a form to start the process, go to www.cms.gov/nosurprises or call 800-985-3059. For questions or more information about your right to a Good Faith Estimate or the dispute process, visit www.cms.gov/nosurprises or call 800-985-3059. Keep a copy of this Good Faith Estimate in a safe place or take pictures of it. You may need it if you are billed a higher amount. If you have questions or concerns, please reach out.

I currently accept the following insurance plans: AllWays Health Partners (MGB Health Plan), Atena, Blue Cross Blue Shield, Harvard Pilgrim (Pt 32 Health), Optum, and United Behavioral Health.

If you want additional low-cost options, please check out Open Path ($40-$70) or your local community health center. 

If you want to get reimbursed by your insurance, I can provide a superbill for you to submit for out-of-network coverage. Please schedule a free consultation to discuss this.

Individual 60-minute sessions are $175. If you use insurance, you are responsible for your co-payment fee, which will be charged to the card on file at the end of each completed session.

Cancellations occurring within 24 hours of the scheduled session will incur the full session fee of $175 and an additional fee for rescheduling. This policy is in place due to the dedicated time reserved for you in the schedule.

The frequency of your sessions can be determined after your initial intake session. Depending on your individual needs, you may benefit from weekly 60 min sessions or bi-weekly sessions. Most importantly, you choose the frequency that works best for you and one to which you can consistently commit to ensuring you gain the most benefit from the therapeutic experience.

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