An HMO plan covers a specific group of doctors only.
A PPO plan allows you to choose any doctor in the community--both in and out of network providers are covered. Silver Lake Psychology is an out of network provider.
Silver Lake Psychology takes most PPO insurance plans. You pay only a portion of the cost and we collect the rest from your insurance company. We take this extra step because Silver Lake Psychology believes in making good psychotherapy accessible and affordable.
What is a deductible?
A deductible is the amount of money you must spend on all medical services before your coverage begins. Once the deductible is met, you will have a co-pay. If you have a high deductible, you may still have coverage. If you have an HSA or an FSA, which is a set amount of money your plan provides to help with high deductibles.
With in-network providers, you have a set co-pay. With out of network providers, your co-pay is based on the percentage your plan pays for therapy. Our staff will check your deductible and rates of reimbursement to let you know what your co-pay will be. We will file claims and get paid by your insurance company.
Why choose out of network providers? * Quality: Many highly trained, seasoned therapists choose to remain out of network
*Choice: With PPO plans, you have the right to see out -of- network providers.
*Specialization: You can choose the best therapist for your needs—couples therapy, sexual concerns or modern technology-based therapies like EMDR, neurofeedback and sensorimotor therapy are offered by out of network therapists. *Access: No wait lists. Get seen quickly.
*No gatekeepers: No referrals needed from your primary care doctor—simply book an appointment and our staff will take care of the paperwork needed to process your insurance claims.
Plans we work with:
Anthem Blue Cross, Blue Cross (of any state), Optum, Cigna, Aetna, Writers Guild, Motion Picture Insurance, SAG, Directors Guild, Harrington Health, United Health Care and Value Options.
Due to Blue Shield's policy of sending checks meant for the doctor directly to the patient, we charge up front and then file claims on your behalf. We do not work with: Medi-Cal, Medicare, Kaiser, EPO or HMOs
Understanding In and Out Network:
If you have a PPO plan, you have a right to see an out of network provider. We collect a co-pay from you and they pay us the rest. Silver Lake Psychology is an out of network provider.
Insurance companies pay a portion of our fee (depending on your plan, typically ranges from 50-80%).
As a courtesy to our clients, staff therapists will call and check your specific benefit plan and inform you about your coverage for therapy. Simply bring your insurance card to your first visit and your therapist will call after the first session. You are responsible for the first session fee of $100 (unless you have insurance coverage).
Why is my copay higher with out of network providers?
Many insurance plans provide a lower reimbursement rate for out- of- network providers. However, because we are not under a contract with your plan, we can waive some of your balance to assist in making therapy more accessible and affordable. Silver Lake Psychology will file claims with your insurance company. We collect a co-pay from you and they pay us the rest. However, our co-pay is slightly higher at $45. Regardless of network status, the deductible must be met first before your coverage begins. Your out-of-network deductible may be higher than your in-network deductible. Our team will check your deductible for you. Some plans provide an FSA or HSA card that covers costs until the deductible is met. You may want to check to see if you have one.
What if I don't have insurance?
Silver Lake Psychology offers sliding scale fees for as low as $100 per session. You can also schedule your sessions to be weekly, bi-weekly or monthly. We offer these reduced rates to meet the needs of the community and to make therapy affordable and accessible to everyone.
Standard rates per session for therapy at Silver Lake Psychology:
45 Minute Session $150 60 Minute Session $185
As a service to our clients, our staff work with most insurance companies to determine the copay instead of asking the patient to pay up front and offering a receipt or “superbill.” Your psychologist will determine after speaking with your insurance plan what portion of this total you will be responsible for.
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