Fees and Insurance

Fees

Most people have insurance that will cover part or all of our fees for therapy services.  If we are in-network with your insurance, we will file claims for you. Most insurance plans require you to make a co-pay or deductible payment.  We request payment at the time of services.

You may also elect to self-pay if you do not have insurance, or if we are out of network.

If someone else is paying for your services (such as a parent), we request that you use our auto-pay system. More information about the auto-pay is available under Fees/Payment and Auto-Pay

If your services become paused for non-payment, setup of auto-pay through the client portal allows services to continue.


Insurance we are in-network with:

  • Aetna
  • Anthem
  • Blue Cross/Blue Shield
  • CareSource Marketplace
  • Medicare (Federal only, no Advantage Plans)
  • IU Health Plans
  • IU Health Plans Select and Premier
  • SIHO
  • United Behavioral Health (UBH)
  • United Health Care (UHC)
  • UMR
  • *Please note. Some plans “carve out” mental health benefits and in these cases, we are typically out-of-network. Please call your plan to confirm we are in-network with your mental health benefits before starting services.

We do not take:

  • Ambetter
  • Anthem Marketplace Plans
  • Cigna
  • HIP (Healthy Indiana Plan)
  • Medicaid plans/Hoosier Healthwise
  • Medicare Advantage plans

Lapsed Insurance/Change of Insurance

If your insurance lapses, or your insurance changes and you do not inform us, you will be responsible at the self-pay rate for any services you have received during that time frame. If we are in-network with your new insurance, we start billing your new plan from the date you inform us of the change. We are not able to backdate insurance claims. Clients will owe self-pay rates for any denied sessions due to incorrect insurance information.

If you opt to see a provider who is not in your network (self-pay), we do not store your insurance information. If you change providers later to an in-network provider, it is your responsibility to give us your insurance information at that time if you decide you want to file insurance claims.

Secondary Insurance

  • If you have two policies, one will be primary and one will be secondary. 
  • We are not able to take clients who have secondary insurance.
  • Clients do not get to choose which one is primary and which is secondary. There is an order, set by the insurance industry. Typically your employer- based plan will be primary. If you have commercial insurance and Medicaid/HIP, the Medicaid/HIP will be secondary.

Self-Pay Therapy

If you are not using insurance, or if we are out of network with your insurance, you can receive services as a self-pay client. Our self-pay rate for intake is $175. Ongoing sessions are $150 per hour.


No Shows/Late Cancellations

We require a 24-hour notice to cancel an appointment so your therapist can reschedule your slot with another client. We send automated appointment reminders to you at 48 hours and again at 24 hours prior to your appointment. By not canceling within the required time frame, or failing to show for your appointment, you will incur a fee of $100 for individual/family therapy. A $40 no show/late cancel is charged for missed group therapy appointments.

Insurance does not cover the late no show fees. We may require you to pay your fee before you may reschedule. Failing to show for your intake requires paying the fee before rescheduling. Clients who cancel/fail to show for an intake a second time cannot schedule again.

Services will discontinue for clients who cancel more than three times in a year, even within the allowed time frame. Our community has long waitlists for mental health services, and we need to reserve treatment time for clients who will use it.


Crisis Care/After Hours Services

If you have a crisis, we will of course help you. However, our practice is not designed for clients frequently needing crisis care, and our clinicians are not on-call.

If you have:

  • Been hospitalized in the past six months
  • Issues with frequent suicidal thoughts or behaviors, or have active psychotic symptoms

please discuss this with the office manager during the assignment process so that we can determine if our practice is an appropriate match for your needs.

If you require hospitalization, or need after hours crisis care, your therapist typically handles this by phone. Insurance does not cover phone calls to coordinate care and these are billed at the self-pay rate as an additional service.


Case Management

Requests for additional services outside of therapy sessions (such as letters, phone calls, or reports to outside parties) are not a benefit of your health insurance coverage. For these situations, $150 charge (prorated for less than an hour) occurs. We do not charge for routine coordination, such as updates to your family doctor, or coordination with your insurance.


Court Services

Spencer Psychology does not provide general court services, such as custody evaluations or fitness for duty assessments. However, if you are a regular therapy client and become involved in a court matter during the course of treatment, your attorney may decide to subpoena your therapist. In this case, court services are billed at $175 per hour for all clinicians. This includes writing reports, preparation time for hearings, meeting with the attorney, waiting time at court and testimony.

If the hearing is outside of Monroe County, travel time is also billed at $175 per hour. If there is more than one party to the court hearing/trial, court fees are paid by whichever party has sent the subpoena. We require a retainer for the full estimated amount at least one week prior to any court appearance. We will provde an itemized statement after completion of the service. After completion of the service, an adjustment to your bill occurs for any under-estimate of the fee as well as a refund for or any overestimate of time needed.


Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to inform 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 of their ability, upon request or at the time of scheduling health care items and services, to receive a “Good Faith Estimate” of expected charges.

  • You have the right to receive a “Good Faith Estimate” explaining how much your medical 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 bill for medical items and services.
  • You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
  • Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or 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.