Rates and Insurance

RATES

$200 - 60 minute Initial Diagnostic Evaluation

$165 - 50 minute Individual Therapy Session

INSURANCE

IN-NETWORK : 

 

Anthem (All PPO plans)

**I am out of network with Anthem Healthkeepers, Medicaid and Medicare Plans**

 

Through Headway only (please visit Headway's website here to learn more)

  • Aetna

  • United Health Care/Optum

** Please contact your insurance provider prior to us meeting to confirm that I am an in-network provider. As well as, if your coverage includes mental health benefits, specifically if it covers online mental health therapy (or telemental health services)**

OUT-OF-NETWORK:

I am more than happy to provide you with a super bill that includes relevant information needed to submit to your insurance provider or employer for possible reimbursement. Services may be covered in full or in part by your health insurance plan. Please contact your provider to verify how your plan compensates you for online mental health services.  Some questions to ask include:

 

  • Do I have mental health/behavioral health benefits?

  • Is there a deductible that I have to meet before benefits will kick in?

  • What is the reimbursement rate for out-of-network providers?

  • Do I need pre-approval or a referral?

  • How many sessions per calendar year will my plan cover?

  • Does my plan cover online mental health therapy (telemental health)?

NO SURPRISES ACT - GOOD FAITH ESTIMATE:

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide a good faith estimate of expected charges for items and services to individuals who are not enrolled in a plan or coverage or a Federal health care program, or not seeking to file a claim with their plan or coverage both orally and in writing, upon request or at the time of scheduling health care items and services. It is used by health care providers to inform individuals who are not enrolled in a plan or coverage or a Federal health care program (uninsured individuals), or individuals who are enrolled but not seeking to file a claim with their plan or coverage (self-pay individuals) of the expected charges they may be billed for receiving certain health care items and services.

 

In summary:

  • You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost.

  • Under the law, health care providers need to give patients 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 receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services.

  • You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.

  • 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, visit www.cms.gov/nosurprises.

PAYMENT

Payment by credit/debit card is expected at the start of each appointment. A receipt will be sent via email once payment is made.

CANCELLATION 

I require 24 hours notice for all canceled appointments, to include intake consultations. If patients or prospective patients do not provide at least 24 hours notice, they will be required to pay the full cost of the session. Please note, your insurance company will not pay for a missed session. Therefore, if you cancel an appointment without 24 hours notice, or if you fail to show up to a scheduled appointment, you will be responsible to pay the full session fees for any missed sessions.

ADDITIONAL QUESTIONS

Check out my FAQ page for any additional questions you may have. If you cannot find the answer, email info@drjguevara.com or submit a message on the contact page. I will get back to you as soon as I can.