Insurance & Fees

Sessions are charged at $225 for an initial session and $185 for ongoing sessions. Sessions last 53-60 minutes.

 

The insurances I accept are:

Optima

Tricare

 

Due to the variability of insurance plans, I suggest that you call your insurance company to confirm that my practice participates with your insurance plan, that online therapy is covered (CPT code 90837 with modifier 95), and that you are aware of your benefits (deductible, co-pay, number of visits). Session fees and co-pays are due when services are rendered.

If you elect to use insurance coverage, session fees will be paid to me by your insurance company at the contracted rate between your insurance company and Jeanene. Deductibles and co-pays will be paid by you according to your insurance plan.

For clients who see me as an out of network provider, I will provide you with a super bill to send to your insurance company to be eligible for reimbursement according to the details of your plan. In this case, the full session fee is due at the time of service.

For clients who are private pay, waive their insurance or do not have insurance, full session fees are due at the time of service.

The decision to use insurance for behavioral health is a personal one.

I am happy to discuss this with you.

The session charge of $175.00 will be used to calculate other professional services you may need, and will be broken down into 15 minute increments when services are provided for periods of time outside of those detailed above.  Other services include letter or report writing, telephone conversations lasting longer than 15 minutes, attendance at meetings with other professionals you have authorized, preparation of records or treatment summaries, and time spent performing any other service you may request. Jeanene Wolfe, LCSW does not provide services for legal proceedings unless mandated by the court. If you become involved in legal proceedings that require your clinician’s participation, you will be expected to pay for all professional time even if your clinician is to testify for another party. Because of the labor intensity of legal involvement, your clinician charges 250.00 per hour for preparation, and any canceled sessions resulting from working on your case during regular business hours, travel time and costs, and attendance at any legal proceeding.

 

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, like a copayment, coinsurance, or deductible. You may have additional costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” means providers and facilities that haven’t signed a contract with your health plan to provide services. Out-of-network providers may be allowed to bill you for the difference between what your plan pays and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your plan’s deductible or annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise medical bills could cost thousands of dollars depending on the procedure or service.

 

You’re protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most they can bill you is your plan’s in-network cost-sharing amount (such as copayments, coinsurance, and deductibles). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these
post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers can bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other types of services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get out-of-network care. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have these protections:

  • You’re only responsible for paying your share of the cost (like the copayments, coinsurance, and deductible that you would pay if the provider or facility was in-network). Your health plan will pay any additional costs to out-of-network providers and facilities directly.
  • Generally, your health plan must:
    – Cover emergency services without requiring you to get approval for services in advance (also known as “prior authorization”).
    – Cover emergency services by out-of-network providers.
    – Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
    – Count any amount you pay for emergency services or out-of-network services toward your in-network deductible and out-of-pocket limit.

If you think you’ve been wrongly billed, please use the following resources:

The federal phone number for information and complaints is: 1-800-985-3059].

Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law.

(757) 515-2693

jeanene@jeanenewolfelcsw.com

Anywhere in the state of Virginia