Rates & Insurance

We have multiple staff members who charge various fees for services, such as a diagnostic interview, couples therapy, individual therapy, medication management or family therapy.  Insurance plans have a variety of out-of-pocket costs and it is not possible to provide an exact estimate of all plan costs.  Some of our patients do not want any record of mental health services sent to their insurance provider and choose to be self-pay.  Other patients do not have a mental health benefit.

To avoid misunderstanding, we request that you speak with our office manager, Anne Staley, about the services you are seeking and whether or not you will be using insurance or self-pay.   We will then be able to provide you with an accurate estimate of your out-of-pocket cost before you come to our office.  During your first session, you will be provided an informed consent form that will detail fees in writing.

None of our clinicians currently bill Medicaid or Medicare.  If we do not directly bill a third party payer or insurance plan, a patient can choose to pay our clinicians directly and then be provided documentation to turn in to your insurance plan to be reimbursed.

Rates

Our staff charges different rates, depending on the service you receive.  In addition, different insurance plans have different out of pocket expenses (ranging from zero to high deductible in which the insurance will not pay until a patient has paid several thousand dollars of medical expenses out of pocket).

We will ensure that you understand your clinician’s rates prior to your first session, but we can’t make any guarantees about payment from your insurance company and always recommend that you contact them to determine your out of pocket expense and whether or not they will pay for our services.

Here are some examples of our cash fees.  Please note that these fees vary by provider.

Dr. Spriggs (Psychologist):
Intake:  $175.00
Follow up session:  $140.00

Dr. Yates (Social Worker):
Intake:  $150.00
Follow up session:  $120.00

Our office manager can provide a more detailed explanation of our fees and during your initial session, your clinician will again clarify any questions about our services and fees.

Insurance

Depending on your current health insurance carrier or employee benefit plan, it is possible for services to be covered in full or in part. Please contact your insurance carrier to verify your plan’s benefit for mental health services.

We recommend asking these questions to your insurance provider to help determine your benefits:

  • Does my health insurance plan include mental health benefits for “outpatient mental health services provided in an office setting”?
  • Do I have a deductible? If so, what is it and have I met it yet?
  • What is my co-pay for outpatient mental health services provided in an office setting?
  • Does my plan limit how many sessions per calendar year I can have? If so, what is the limit?
  • Do I need authorization from my primary care physician in order for services to be covered?

Our clinicians are currently in-network with the following plans:

  • Blue Cross and Blue Shield – Dr. Spriggs, Mr. Hunt, and Ms. Jackson.  Please note that there are a few Blue Cross Blue Shield plans that are restricted to only providers in certain health care networks.  We are not able to directly bill for some of these plans.
  • Aetna -Dr. Spriggs, and Dr. Yates
  • Carolina Behavioral Health Alliance — Dr. Spriggs, Ms. Jackson, and Dr. Yates
  • Cigna – Dr. Spriggs, and Dr. Yates

Please note that none of our staff are currently credentialed with other plans (including Medicaid and Medicare).  If you have a plan that we are not credentialed with, it is likely that your plan may pay for a portion of our services as an out of network provider.  You would need to pay our staff directly and then would be provided documentation (known by insurance companies as a “Super-Bill”) for you to submit to your insurance to be reimbursed.

Payment

Our clinicians accept cash, check and all major credit cards as forms of payment.  If you register for the patient portal, you are able to pay your balance from home.  You may also pay by calling our office manager and providing credit or debit card information by phone.

Cancellation Policy

If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you may be charged a cancellation fee.  Piedmont Counseling Center doesn’t want to charge anyone for a no-show or late cancellation, but it is very important for us to have a minimum of 24 hours notice if you must cancel or change an appointment.

Any Other Questions

Please contact us with any additional questions you may have. We look forward to hearing from you!

 

 



129 Allen Street
Kernersville, NC 27284

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info@pmtcounseling.com
(336) 293-7406

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