Insurance
>Do we accept insurance?
>Do I HAVE to use my insurance?
It is your responsibility to know your insurance benefits. Your clinician will bill for the first session through Simple Practice. This will determine what you will be charged for a deductible or copay. You will be responsible for paying for copays or deductibles and must have a valid credit card with your clinician. I
Many plans are different and ‘cover’ other services. Mental Health or specific diagnoses are not always covered. It is your responsibility to verify your insurance benefits before your first session and to disclose if you have “secondary insurance.” Failure to do so may result in you paying the full amount for the session. Your therapist will submit the first claim to insurance shortly after the initial session. It can take up to 4 weeks to receive an Explanation of Benefits (EOB) from your insurance. Your clinician will do their best to verify coverage on their end (reviewing your insurance card and checking online). Ultimately, you will be responsible for any monetary differences once the EOB is returned.
Ways of Play Counseling Services LLC will do their best to communicate to the Insurance company the need for continued services. However, after two attempts to contact and negotiate services, Ways of Play will return responsibility to the client. At this point, the client may become responsible for any missed payments at the contracted rate.
It is your right to decide whether to utilize your insurance benefits. Please take the time to make an informed decision as to what will be best for you and your family. Please contact your therapist if you have any questions about therapeutic documents and diagnosis.
The client’s session fee is due at the time of service. This fee is determined by insurance or previously agreed-upon payment for service. Ways of Play Counseling Service will accept checks or credit cards (including FSA and HAS cards). Credit cards are processed through Stripe via Simple Practice. Clients are required always to keep an active card on file. Credit card charges are run on the day of the scheduled session. Should your card be compromised, please inform your clinician immediately. Clients can request invoices and Superbills at any point during. Requests need to be made in writing (secure messaging or email) to the primary clinician or Marie at [email protected].
Ways of Play Counseling Services LLC will provide you with proper documents to submit for out-of-Network Benefits. We will not directly work with any out-of-Network Benefits. Ways of Play will also provide a Good Faith Estimate should you decide not to use insurance.
>Verifying your insurance
Many of our clinicians are paneled by significant insurance companies. You can contact your insurance company to determine if your plan covers your therapist.
Below is an example of what to ask when calling your insurance company to verify your benefits. Please note that the clinician may be paneled with the insurance company, but plans vary from family to family. Please take a moment to check to see if your plan covers mental health.
Questions to ask your insurance company concerning your benefits:
>Reasons for NOT using insurance:
Please click here for an infographic of why insurance may not be an option. Some clients choose not to use their insurance for various reasons. Below is a list of reasons that individuals may choose to decline insurance.
Your right is to decide whether or not to utilize your insurance benefits. Please take the time to make an informed decision as to what will be best for you and your family. Please contact your therapist if you have any questions about therapeutic documents and diagnosis.
>Payments
The session fee is due at the time of service. This fee is determined by insurance or previously agreed-upon payment for service. Ways of Play Counseling Service will accept checks or credit cards (including FSA and HAS cards). Credit cards are processed through Stripe via Simple Practice. Clients are required to keep an active card on file at all times. Credit cards will be running on the day of the session. Should your card be compromised, please inform your clinician immediately.
Clients can request invoices and Superbills at any time. Requests must be made in writing (secure messaging or email) to the primary clinician or to Marie at [email protected].
Ways of Play Counseling Services LLC will provide you with proper documents to submit for out-of-Network Benefits. We will not directly work with any out-of-Network Benefits.
>Other Payment Options:
For Interns and Provisionally Licensed Professional Counselors (PLPC), fees are slightly lower and different for each clinician. Please ask about this option during your initial consultation meeting. If using a sliding fee, you and your clinician will agree upon this price before the first session.
>Graduate Level Interns (Playful Beginnings)
Starting June 2023, Ways of Play will coordinate with the Playhouse Collaborative to support students who are becoming Mental Health Professionals. They must complete direct service hours providing therapy as part of their coursework. These interns are supervised and can provide low-cost treatment. The fee for a Playful Beginning session is low cost.
The length and duration of this session will be determined by the supervisor, the intern, and you. If you want this option, specifically ask about the Playful Beginnings program.
****For more information email [email protected] or go to www.theplayhouseinc.com
>Non Therapeutic Services
Some services our clinician's provide may not be covered by insurance and be charged to the client directly. Some of these services include:
- Many of our clinicians accept United Health Care/Optum, Anthem/ Blue Cross Blue Shield, Aetna, Missouri Medicaid, Home State Health, MO Care, Health Link and Ambetter.
- What to do if your insurance company is not listed?
- you may be able to receive reimbursement for fees as an out of network provider. Please contact us to see if I am on your insurance company’s panel. A sliding fee scale is also available based on financial need.
>Do I HAVE to use my insurance?
- No, you do not have to use insurance if you choose not to.
- Some people choose not to use insurance because Insurance companies REQUIRE a diagnosis in order to pay for your session. You may not want a documented diagnosis (as it is permanently recorded. Also, your diagnosis may not be reimbursed by your insurance. Insurance companies can also limit the number of visits they will pay or require prior authorization before reimbursing. Insurance can also request your information at any time for “review.”
- You have the option to use a sliding fee. A sliding fee is a fee system in which a client can slide up or down in accordance with their household income and ability to pay.
It is your responsibility to know your insurance benefits. Your clinician will bill for the first session through Simple Practice. This will determine what you will be charged for a deductible or copay. You will be responsible for paying for copays or deductibles and must have a valid credit card with your clinician. I
Many plans are different and ‘cover’ other services. Mental Health or specific diagnoses are not always covered. It is your responsibility to verify your insurance benefits before your first session and to disclose if you have “secondary insurance.” Failure to do so may result in you paying the full amount for the session. Your therapist will submit the first claim to insurance shortly after the initial session. It can take up to 4 weeks to receive an Explanation of Benefits (EOB) from your insurance. Your clinician will do their best to verify coverage on their end (reviewing your insurance card and checking online). Ultimately, you will be responsible for any monetary differences once the EOB is returned.
Ways of Play Counseling Services LLC will do their best to communicate to the Insurance company the need for continued services. However, after two attempts to contact and negotiate services, Ways of Play will return responsibility to the client. At this point, the client may become responsible for any missed payments at the contracted rate.
It is your right to decide whether to utilize your insurance benefits. Please take the time to make an informed decision as to what will be best for you and your family. Please contact your therapist if you have any questions about therapeutic documents and diagnosis.
The client’s session fee is due at the time of service. This fee is determined by insurance or previously agreed-upon payment for service. Ways of Play Counseling Service will accept checks or credit cards (including FSA and HAS cards). Credit cards are processed through Stripe via Simple Practice. Clients are required always to keep an active card on file. Credit card charges are run on the day of the scheduled session. Should your card be compromised, please inform your clinician immediately. Clients can request invoices and Superbills at any point during. Requests need to be made in writing (secure messaging or email) to the primary clinician or Marie at [email protected].
Ways of Play Counseling Services LLC will provide you with proper documents to submit for out-of-Network Benefits. We will not directly work with any out-of-Network Benefits. Ways of Play will also provide a Good Faith Estimate should you decide not to use insurance.
>Verifying your insurance
Many of our clinicians are paneled by significant insurance companies. You can contact your insurance company to determine if your plan covers your therapist.
Below is an example of what to ask when calling your insurance company to verify your benefits. Please note that the clinician may be paneled with the insurance company, but plans vary from family to family. Please take a moment to check to see if your plan covers mental health.
Questions to ask your insurance company concerning your benefits:
- I am planning to start mental health therapy. Do I have in-network mental health benefits?
- Are there mental health diagnoses that are not reimbursable?
- Do I need prior authorization?
- How many sessions will I be approved for a calendar year?
- Are there any restrictions for telehealth or virtual sessions?
- What will my out-of-pocket cost be, approximately (you are asking to see if there is a deductible, copay, or co-insurance)?
- (Once you have verified mental health coverage, you can verify if your chosen provider is also covered.)
- I also need to know if _______________ (provider’s full name) is a covered provider.
- I also need to know if _______________ (provider’s full name) is a covered provider.
>Reasons for NOT using insurance:
Please click here for an infographic of why insurance may not be an option. Some clients choose not to use their insurance for various reasons. Below is a list of reasons that individuals may choose to decline insurance.
- The Insurance company can request your therapeutic documents (progress notes, diagnosis, and treatment plans) at any time. By using your insurance, your clinician is not required to gain your consent to send these documents.
- The Insurance company can determine what type of treatment they will cover and what type they will not. For example, an insurance company may not consider your diagnosis as ‘medically necessary’ or will not provide couples counseling.
- The Insurance company requires a diagnosis in order to pay for the session. The documented diagnosis will become a part of your medical record and may impact other aspects of a client’s life, such as school, military service, or federal career. It may also be considered a pre-existing condition for life insurance.
Your right is to decide whether or not to utilize your insurance benefits. Please take the time to make an informed decision as to what will be best for you and your family. Please contact your therapist if you have any questions about therapeutic documents and diagnosis.
>Payments
The session fee is due at the time of service. This fee is determined by insurance or previously agreed-upon payment for service. Ways of Play Counseling Service will accept checks or credit cards (including FSA and HAS cards). Credit cards are processed through Stripe via Simple Practice. Clients are required to keep an active card on file at all times. Credit cards will be running on the day of the session. Should your card be compromised, please inform your clinician immediately.
Clients can request invoices and Superbills at any time. Requests must be made in writing (secure messaging or email) to the primary clinician or to Marie at [email protected].
Ways of Play Counseling Services LLC will provide you with proper documents to submit for out-of-Network Benefits. We will not directly work with any out-of-Network Benefits.
>Other Payment Options:
For Interns and Provisionally Licensed Professional Counselors (PLPC), fees are slightly lower and different for each clinician. Please ask about this option during your initial consultation meeting. If using a sliding fee, you and your clinician will agree upon this price before the first session.
>Graduate Level Interns (Playful Beginnings)
Starting June 2023, Ways of Play will coordinate with the Playhouse Collaborative to support students who are becoming Mental Health Professionals. They must complete direct service hours providing therapy as part of their coursework. These interns are supervised and can provide low-cost treatment. The fee for a Playful Beginning session is low cost.
The length and duration of this session will be determined by the supervisor, the intern, and you. If you want this option, specifically ask about the Playful Beginnings program.
****For more information email [email protected] or go to www.theplayhouseinc.com
>Non Therapeutic Services
Some services our clinician's provide may not be covered by insurance and be charged to the client directly. Some of these services include:
- Therapeutic Visits
- Professional Letters
- Court Appearances
- Documentation Requests
| ways_of_play_detailed_services_12.29.21.pdf |