FEES AND INSURANCE

Fees for services range from 135.00 per session to 220.00 per session, depending on service and on clinician. Rates may be lower if your provider is in-network with your insurance company. Feel free to ask the rates of the provider you are interested in seeing. 

INSURANCE 101

Insurance benefits vary greatly by insurance company and by whether your provider is contracted with your specific insurance company. Even when your preferred therapist is not contracted with your insurance company you may still be eligible for significant insurance benefits.  Ask your insurance company the following information and specify that it is for Outpatient Mental Health Counseling:

COVERAGE BY MORE THAN ONE INSURANCE PLAN:

If you are covered by more than one insurance plan, then it is CRUCIAL that you know which insurance company is primary and which is secondary. Generally, the insurance company provided by YOUR employer is primary, followed by your spouse’s or significant other’s policy – even if you had your partner’s policy first.  Call your insurance companies to clarify.  If you have Medicare and another policy such as a supplementary policy, you also need to clarify which is primary.  We have had cases where the insurance company came back after more than a year once they realized they were not primary. Although we did our best to rectify the situation the patients ended up with the job of working it out with the insurance companies. In some cases, they ended up owing us a significant amount of money.  

WHAT DO YOU NEED FROM ME TO ACCESS MY INSURANCE ELIGIBILITY AND BENEFIT INFORMATION?:

At times we are able to look up your insurance eligibility and benefits for you. To access your insurance benefit information we need to know: 

* Your name

* Your date of birth

* Your address

* The policyholder’s name (if not you)

* The policyholder’s date of birth (if not you)

* The policyholder’s address (if not you)

* Your policy number

* Your group number

* The phone number on the back of the card for your insurance company. It may be a general number, the provider’s number, and/or the number for mental health, behavioral health, or substance abuse.  

***IMPORTANT***

*YOUR MEDICAL INSURANCE COMPANY MAY NOT ACTUALLY BE THE INSURER OF YOUR MENTAL HEALTH BENEFITS*

It is important for you to check the back of your insurance card for a phone number for “Mental Health,” “Substance Abuse,” “Behavioral Health” or some similar phrasing. If those words are present then your mental health insurance may, or may not, be provided by a different company than that listed on the front of your insurance card. Call the number to learn which insurance company provides your mental health benefits.  Most recently we have found that Anthem Blue Cross and Cigna “carve out” mental health benefits with some of their policies. 

HOW DO I KNOW IF MY PROVIDER IS AN IN-NETWORK PROVIDER?

 Even if Three Peaks Counseling is listed as a covered business your specific provider may or may not be considered in-network under your plan. Feel free to contact your insurance company to see if the provider you are interested in meeting with is listed. If not, call Three Peaks Counseling and we can tell you which of our providers are in-network with your plan. Most of our providers are in-network with Blue Cross Blue Shield and Aetna.

The services we provide are usually considered as outpatient mental health office visits, though we are occasionally considered specialists, depending on the insurance plan. To help you determine your costs your insurance company may ask about specific CPT codes. The CPT codes typically used at Three Peaks Counseling are: 

90791, 90839, 90837, 90834, 90832, 90853, and 90847   

OUT-OF-NETWORK BENEFITS

As a convenience to you we are able to submit both in- and out-of-network claims to your insurance company. To use your out-of-network benefits you pay your provider their regular fee. We will then submit the claim to your insurance company and then they will either pay you, or pay us, what you are owed. If they pay us we will either apply it to a future visit or provide you with a reimbursement check, whichever you prefer. 

TYPES OF PROVIDERS AT THREE PEAKS COUNSELING

The types of providers at Three Peaks Counseling are Psychologists (LP), Licensed Professional Counselors (LPC), Licensed Clinical Social Workers (LCSW), or Licensed Marriage and Family Therapists (LMFT).  These clinicians provide consultations and psychotherapy (talk therapy). 

We do not have providers who are able to prescribe medication such as psychiatrists (MDs or DOs) or nurse practitioners (NPs) in our group.  

SHOULD I USE MY INSURANCE BENEFITS AT ALL? 

(Please note that the following information should be verified independently by you. We are providing this information for you to consider when deciding whether or not to use your insurance benefits).

WE ARE HERE TO HELP YOU FIND THE BEST THERAPIST FOR YOU AND THEN TO HELP YOU GET WHAT YOU ARE ENTITLED TO FROM YOUR INSURANCE COMPANY. DO NOT HESITATE TO CONTACT US WITH ANY QUESTIONS.