Insurance and Rates

INSURANCE AND RATES

We offer services to companies, groups, and individuals!

Insurance

Providers at The Balm Center accept the following major insurances: Aetna (including Aetna Better Health), BlueCross/Blue Shield (including Anthem, Carefirst, and Highmark), Cigna, PEIA, Peak, Maryland Medicaid, Medicaid of West Virginia, The Health Plan, Tricare East, Unicare, and United Healthcare (including UMR). We also accept Self Pay and Insurances with Out-of-Network Benefits.

We are pending acceptance of other major insurance companies including: Molina and others. Currently, we are considered out-of-network for these insurance companies. For these companies, clients can have insurances pay The Balm Center directly through their out-of-network benefits. Or, clients can pay the full fee at the time of service and can then choose to submit to their insurance for reimbursement through their out-of-network benefits.

We provide a Statement for Reimbursement (“Superbill”) through our secure online portal to submit to your insurance company if you choose to seek reimbursement. The majority of our clients have some out-of-network benefits, and benefits often cover 50% or more of our fees. Couples therapy is not always covered by insurance. We recommend you check with your insurance company. 

Out-of-network benefits vary by insurance carrier and policy, and it can be confusing. We understand. You can learn more about how your insurance company will reimburse your therapy expenses from The Balm Center by calling your Insurance Member Services Phone Number and asking the following questions: 
  • Does my plan include out-of-network benefits?
  • If yes, what is the out-of-network deductible?
  • Are individual psychotherapy services (CPT code 90834 or 90837) covered by my out-of-network benefits? 
  • If yes, what percentage of the Allowed Amount is covered once my deductible is met?
  • Where do I send claims for reimbursement?

No Surprises Act & Good Faith Estimate

Under the No Surprises Act, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to be aware of any charges and to receive an estimate prior to receiving these services. You can ask for a Good Faith Estimate before you schedule a service, or at any time during treatment. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate. For questions or more information about your right to a Good Faith Estimate (GFE), or how to dispute a bill, see your GFE document, or visit www.cms.gov/nosurprises. The Balm Center is an out-of-network therapy practice (also known as “fee-for-service” or private pay). The following document serves as notification of these rights and protections:



Additionally, you have the right to receive a Good Faith Estimate (GFE) of the cost of services typically offered by your therapist over a 12-month period. As always, each client may decide how long they would like to participate in mental health care and we will collaborate with you on a regular basis to determine how many sessions you may need. 

If you receive a bill for services that is at least $400 more than your Good Faith Estimate (GFE), you may file a dispute.

For questions or more information about your right to a Good Faith Estimate and this federal requirement, visit www.cms.gov/nosurprises.

Rates & Payment

The rate for a diagnostic evaluation is $225. Our therapy rates are $160 for individual sessions and $185 for couples and family sessions. We accept credit card/debit card and HSA/FSA payments at the time of service. There is no additional service fee for using credit, debit, or HSA/FSA cards. You will submit payment on our secure patient site before or at time of service.

Cancellation Policy

Our practice policy requires 24 hours notice of cancellation. If you do not cancel and do not show up for your scheduled therapy appointment, you will be charged a fail to arrive fee of $60.00. If you cancel in less than 24 hours but we are able to reschedule within the same week, we may waive the $45.00 late cancel fee. 
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