Sheila Bryan, LICSW, Psychotherapist
Sheila Bryan, LICSW, Psychotherapist
Counseling for teens and adults
Now celebrating 12 years in business est. 2012
There are insurance company guidelines you need to find out about regarding your particular insurance plan because insurance companies have many different plans and each plan has its own requirements about payment to providers. Please see below what it is that I need you to do BEFORE you come in for your first visit and cost per session if you have a deductible/coinsurance to meet before your co-pay kicks in. I know this may sound like a lot to do but I feel it’s better to be informed about your behavioral health benefits before you see any therapist, including me, so you know exactly what your benefits are and how much you are financially responsible for BEFORE seeing me for your first visit. If you have any questions, please feel free to contact me at 603-785-2948 or sabryan1965@gmail.com.
1) Call, do not visit the website of your insurance company, to make sure that I am “in-network” for you. Insurance companies do not always update your information so you may not get the current information about your plan. The phone number should be on the back of your insurance card. Some insurance cards have a phone number specifically for behavioral health. It will save you money down the road if you find out after your first few visits that I am not “in-network” and you have to pay me the “out-of-network” rates or pay my private pay rate, which is $150 for the first session and $100 per session thereafter. Blue Cross Mass clients, please be aware that there can be issues with payment because I have to bill through Anthem in NH, not Blue Cross Mass (their rules). Some BC Mass plans require a PCP referral for cross-border services, meaning if your PCP is in MA and you live in MA, you may need your PCP to refer you to me.
2) Ask them if you need a pre-authorization or pre-certification before coming to see me. Some plans require a referral from a doctor (for example, your primary care physician, called a “PCP”) before they will authorize payment. Again, it will save you money down the road if you find out after a few sessions that you needed a PCP referral to see me and did not get one. I will have to charge you my private pay rate for the sessions that you have already seen me for, before you can continue with me and while we wait for the insurance company to make a decision whether to reverse the denial and approve payment for the sessions you have already seen me for. Your other option is paying me for the visits you already had with me out of your own pocket, which will allow you to continue to see me if you want to pay my private pay rate. If we are able to get a reversal on a denial, then I will reimburse you for the money you paid me, but only if your insurance company reverses their initial denial of services.
3) Ask what your co-pay or co-insurance will be and if you have any deductibles to meet before you can use your co-pay. Deductibles need to be paid first before you can use your co-pay/co-insurance. This means you will be charged the rate I am allowed to charge the insurance company to see you, not my private pay rate. For example, if you have Blue Cross Mass or Anthem, I am allowed to charge $141.66 for the first session, and $100 for all sessions thereafter if you are seeing me for individual therapy (as of November 2024 and this is to my knowledge, your plan may be different). I do not know the out of pocket costs for family (under which couples counseling is billed) as Anthem/Blue Cross has not sent me an updated fee schedule.
Also, I do not do free consultations. If you come to my office to see me and decide that I am not the right therapist for you, I will still need you to pay me (if you have a co-pay or deductible) and I will bill your insurance company for the visit.
Medicare clients: Please be aware that if you do not have a secondary insurance that pays for your co-pays, you will need to pay me a co-pay of 20% of what Medicare pays me. There is a deductible required by Medicare B, which is $240 for 2024, that also needs to be paid once you start using your benefits at the beginning of each year. Also note that most Medicare Part B supplemental plans (private insurance companies) DO NOT COVER THE DEDUCTIBLE, so be sure to check your supplemental plan re: this issue as I have had Medicare clients get upset with me about it when I have no control over what plan someone chooses each year.
Please be aware that if you do not have a secondary insurance that pays for your co-pays, you will need to pay me a co-pay of 20% of what Medicare pays me. As a mental health provider, I have no control over what supplemental plan someone chooses, I just go by what your insurances tell me I can get paid. I also cannot advocate on your part about this issue.
For Private Paying clients: My rates as of 11/1/2024 is as follows (also this is what you will owe me if you have private insurance and a coinsurance and/or deductible to meet first): $170 for the first session, which is one hour, then $120 per one hour session thereafter. Longer sessions will be charged according to this pricing, ex., 90 minutes will cost $180).
Thank you for visiting my website! If you have any other questions, please free to call me at 603-785-2948 or email me at sabryan1965@gmail.com, and I will get back to you as soon as I can.