The billing practices of Hawthorn Counseling Group have been designed with the following goals in mind:
• We strive to maintain the affordability of our services to ensure that members of our community can easily access our range of services.
• Billing procedures need to be transparent and clear to those who utilize our services. Regardless of the type of care being provided—psychotherapy, specialized assessment services, divorce coaching or mediation—recipients of our services are fully aware of the costs and payment arrangements from the time of the first appointment. As noted below, the Hawthorn Counseling Group fee schedule and collections policy are available for review at any time—feel free to contact Dr. Jochem at firstname.lastname@example.org if you wish to receive these materials.
• Billing procedures are designed to be simple and efficient, enabling both patients and clinicians to remain focused upon treatment rather than administrative and billing matters.
There are some variations in the customary arrangements for billing and payment, depending upon the service being provided by Hawthorn Counseling Group. Typical billing arrangements for our range of services are described below.
Patients receiving psychotherapy services usually pay for their care in one of two ways:
• Many patients make payment in full over the course of their counseling, at the time that services are provided. Should the patient wish to later submit claims to their health insurance company, such submissions for insurance reimbursement are made either by the patient or by Hawthorn Counseling Group. We can provide you with statements suitable for submitting claims to your health insurance carrier.
• When using health insurance benefits, patients need to determine their out-of-pocket responsibilities at the outset of counseling and, once deductible costs have been met, they may make only co-pay payments at the time of each appointment. In the latter arrangement, Hawthorn Counseling Group submits claims on the patient's behalf to their insurance company and is paid directly by the third-party-payor.
Either of these billing methods are acceptable and it is usually a matter of convenience and patient preference determining the terms which are agreed-upon at the outset of counseling. The clinicians of Hawthorn Counseling Group are contracted with a number of health insurance and behavioral health managed care organizations and patients covered under such plans may be eligible for contractual discounts. However, this also means that patients may be subject to review and/or approval of care by their insurance or managed care company. Under these circumstances, we work with patients and their insurance companies to support their access to their mental health benefits. While Hawthorn Counseling Group will abide by the billing procedures, utilization review requirements and fee schedules with contracted companies, patients should know their own responsibilities for utilizing their health insurance coverage. These responsibilities are described in forms furnished to patients at the outset of counseling (see patient registration forms available on the Downloads page) and include the following:
• If electing to utilized their health insurance to offset the costs of counseling, patients should call their insurance company and/or behavioral health managed care company prior to the first appointment to inquire about their mental health benefits. In this telephone call with their insurance or behavioral health managed care company, patients should determine the following:
• Patients need to ask if the Hawthorn Counseling Group provider they intend to see is listed in the company's provider panel. If the provider is not listed, patients may then inquire about their out-of-network benefits to help determine whether or proceed in arranging counseling.
• Patients need to determine whether prior approval of outpatient counseling is required, either by the insurance/managed care company or through the patient's primary care physician. If prior authorization is necessary, the insurance and/or managed care company may provide an authorization number, which the patient should record and have available at the time of the first appointment. Patients may also wish to inquire if ongoing monitoring of treatment and approval of care is required—some plans are designed to provide an initial authorization of care with subsequent documentation requirements to continue in counseling.
• Patients should ask about the design of their mental health benefits with respect to deductible amounts, co-pay responsibilities and limits on services with respect to covered services and/or limits on the number of sessions per calendar year.
Patients are encouraged to make note of all of this information and bring it along to the first appointment.
Divorce Coaching & Medication Services
Unlike outpatient psychotherapy services, divorce coaching and mediation are not eligible for coverage by health insurance. Payment arrangements for both divorce coaching and mediation are discussed in advance and are agreed-upon in a retainer agreement. For further information regarding the retainer agreement, please contact Dr. Jochem at email@example.com .
Coverage of evaluation services by health insurance plans will depend upon the type of assessment being provided. In many instances, payment for fitness evaluations—whether conducted as a school fitness evaluation of a child/adolescent or a fitness-for-duty assessment of an adult—is covered by the referring school or employer. In these cases, the clinician is contracted directly by the referring organization to provide the assessment and provide recommendations directly to the referral source, operating under the patient's consent. In other circumstances, such as the pre-surgical evaluation of a candidate for gastric bypass, the assessment may be covered by the patient's health insurance plan.
When making payment arrangements for evaluation services, we prefer patients to provide full payment at the time of service, unless an external organization (e.g., a referring school or employer) has entered into an agreement with Hawthorn Counseling Group to cover the cost of the assessment. Should the patient subsequently wish to file a claim with their health insurance company for the evaluation service, Hawthorn Counseling Group will be happy to furnish a statement suitable for claims submission, which will indicate the service provided, dates of service and the patient's payment for the assessment.
Professional Training & Community Education
Speaking fees, whether for presentations provided to a professional gathering or in the context of a community event, are negotiated in advance when planning for the proposed event. Feel free to contact Dr. Jochem at firstname.lastname@example.org to discuss your professional training interests or arrange a community presentation.
Charges for consultation to agencies, hospitals or other organizations are typically negotiated with respect to a specific project or objective, or may be structured as a time-limited consulting arrangement. Feel free to contact Dr. Jochem at email@example.com to discuss the needs of your human services organization or hospital unit.
Further Information About Billing
Contact us at any time at firstname.lastname@example.org or by calling (847) 680-0755 should you wish to obtain a copy of our current fee schedule or receive a copy of our collections policy. Both of these documents are available for your review, upon request.
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