Fees and Insurance
New Leaf Counseling STL is an an out-of-network provider, meaning clients pay the session fee at the time of service, and can submit reimbursement requests to their insurance provider. The session fee is $175 for a 50 minute session. Clients are provided with a monthly superbill (a receipt for insurance purposes), and can submit this for reimbursement. To find out what your out-of-network benefits are, call the number on the back of your insurance card, and use the following helpful questions to get more information.
What is your name and extension number?
Does my policy cover out-of-network Licensed Clinical Social Workers? My therapist is licensed in Missouri, and her license number is 2017015859.
My therapist is willing to provide a statement of Session Dates Attended, the CPT code, and the Diagnosis. Is this acceptable to the insurance company?
Does my policy cover Individual Psychotherapy - CPT code 90834 (a 45 minute session) for my child?
Are there any mental health diagnoses that are not reimbursable?
How many sessions are covered per year?
What is my lifetime maximum for mental health benefits?
What is my Out of Network deductible? (This is the amount you have to pay before they start reimbursing you - and for some insurance companies, this can be prohibitively high)
What is the Allowed Amount of Fee?*
Many insurance companies will reimburse a percentage of the total fee paid. For example, your company may reimburse you 80% of the total fee paid, or $140 for a $175 individual session. Other companies will substitute the $175 fee for what they deem appropriate, regardless of what you paid. For example, your company may say that they will reimburse you 80% of the “allowed amount” of the fee. You paid $175 for an individual session, but your insurance company only allows $60. Therefore, you will be reimbursed 80% of $60, or $48. They may try to withhold this information from you and are actually legally allowed to do so. Ask to speak to a supervisor and say that you cannot plan your medical expense budget without this number.What percentage of the Allowed Amount will be reimbursed?
How do I file a claim? Online, through mail?
Do you require my claim to be submitted within a certain number of days from the date-of-service, in order to be considered for reimbursement? If so, what is that time period?
What is the payment schedule? (In other words, how long does it take for them to process your paperwork and then reimburse you?)
What is the claims department phone number, so I can follow up on the status of my claim at a later date?
During this conversation, make sure to write down answers, and don't be afraid to ask clarifying questions. While it can be confusing, their job is to help you understand your coverage!
A couple more things to consider:
Insurance reimbursements can vary from month to month:
At the beginning of your therapy, there will be a wait until your insurance company begins to pay your benefit.
In January of each year, you won't get any money back until your deductible is met. If you apply other family medical expenses to your deductible, you'll start getting benefits sooner, and more of your therapy will be paid for.
Toward the end of the year, your insurance reimbursements will stop if the number of sessions is limited.
Your out-of-pocket medical expenses can be minimized if your employer offers a pre-tax medical "flexible spending account"
You should ask your accountant about taking a medical tax deduction for psychotherapy.
You may save money with an insurance plan that has a higher premium, but better benefits for out-of-network therapy (called Preferred Provider Organization, or PPO).
Sliding scale
I believe that finding the right therapist is important, and want to do what I can to make my services available to more people. For this reason, I do offer a sliding scale for a limited number of appointments. Call or email me to discuss if you qualify for sliding scale and to see if any openings are available.
Cancellation policy
There is a strict 48 hour cancellation policy for appointments. You will receive an appointment reminder in advance, but it is appreciated if you can make any cancellations or changes as early as possible. This window allows for other clients to book appointments, and to give them time to make arrangements such as time off work or childcare. Clients are charged the full session fee for cancellations within the 48 hour window or for no showing. Please keep in mind that insurance will not cover cancellation or no-show fees.
In the case of inclement weather, emergency, or illness within the 48 hour cancellation window, a phone or video session can be conducted in lieu of an on site session, for the full session rate. If this occurs, please call or text Kathleen directly at 314-499-2994 in order to arrange the phone session.
Keep in mind - if you opt for a phone session, try to find a calm, quiet space in your home where you can have privacy and focus on yourself for the duration of the call.