Rates & Insurance
Using Your Health Insurance at The Oak Inside
The Oak Inside is considered “out of network” with all insurance carriers. It is useful to call your insurance company to understand the “out of network” benefits that you may be able to apply toward our services. For help in understanding how to talk with your insurance company about out of network benefits, please see our Guide to Out of Network Benefits page on this website or click this LINK for the PDF version of our Out of Network Guide
Payment at The Oak Inside:
Counseling Services: All session fees, co-pays, coinsurance, or deductibles are due at the time of service. Clients can pay their fee with a credit card/HSA card/debit card on file at the time of service.
For clients using out of network insurance, clients have an option to request an itemized receipt of payment for services (superbill) which will be provided at the end of each month. This may be used to submit to your insurance company. It is the client’s responsibility to handle this submission.
Evaluation Services: All session fees are due at the time of service. Half of the flat rate assessment fee (see fee schedule below) will be due at the initial assessment appointment with the client. The remaining 50% of the total fee will be charged at the time of the feedback session.
Fee Schedule for Evaluation Services
Intake Session - $175
Every new assessment case includes an intake session with parents or adult clients to discuss concerns and take a thorough developmental history. Discussion will include a determination of what testing would be appropriate and what questions will be answered. If testing is not warranted, referrals to other professionals will be provided
Developmental or Autism Evaluation - $1500 flat rate
24 months- 5 years
- Developmental Assessment
- Adaptive Behavior
- Multi-informant rating scales
- Review of records
- Detailed testing report including background information, scores, interpretation, recommendations, and appropriate diagnoses
- 1-2 Feedback sessions to discuss results of testing and recommendations
Neuropsychological Assessment - $2500 flat rate
- Psychological and neuropsychological testing including cognitive assessment, executive functioning, and/or memory assessment, as needed
- Academic testing for Learning disabilities
- Behavioral, social, autism and/or other developmental measures, as needed
- Review of past records and contact with other providers, as needed
- Detailed testing report that includes background information, current concerns, scores, interpretation, recommendations, and appropriate diagnoses
- 1-2 feedback sessions to discuss results of testing and recommendations
Fee Schedule for Counseling Services
Psychologist - $175
Licensed Professional Counselor or Licensed Clinical Social Worker - $125
Each new therapy case begins with an intake session to help the clinician understand the presenting problems and the client’s history, develop initial goals for therapy, and establish a schedule for treatment. If therapy does not seem appropriate or if the clinician recommends treatment with a specific specialist, referrals will be given at that time.
50 Minute Therapy Sessions
Psychologist - $175/session
Licensed Professional Counselor or Licensed Clinical Social Worker - $125/session
Out-of-Network Insurance Guide
Most health insurance companies provide both IN and OUT of network benefits. In network providers are those doctors, psychologists, and therapists who have an agreed upon contract with the insurance company. Out of network providers do not have a partnership with the insurance company. Depending on your policy, you may have out-of-network coverage. If you do, out-of-network services may be partially or totally covered after deductible. It is best for you to call your insurance company before you schedule an appointment with The Oak Inside.
This guide is provided to assist you with calling your insurance company to check on your out-of-network benefits. The Oak Inside is not responsible for the information obtained using this guide.
Payment at The Oak Inside
At each session, payment is due, unless another payment plan has been established. Clients will pay their fee with a credit card/HSA card/debit card on file at the time of service. Clients have an option to request an itemized receipt of payment for services (superbill) which will be provided at the end of each month. This may be used to submit to your insurance company. It is the client’s responsibility to handle this submission.
The following information will be provided on your superbill:
- Provider’s Name
- Provider’s NPI
- Provider’s license number
- Federal Tax ID number
- DSM-5 and ICD-10 diagnosis codes
- CPT or Procedure codes
How to check your out-of-network coverage and possible out-of-network benefits:
- Plan for 30 minutes to call your insurance company to get these questions answered
- Make sure you have this information ready before your call:
- Insurance card
- Name, date of birth, address, phone number, or possibly social security number of the insured and the person for whom the services will be provided
- Pen and paper/notepad
Questions to Ask Your Insurance
Questions to ask:
- Are there out-of-network benefits for this policy?
- Do I have a mental or behavioral health policy with out-of-network benefits?
- What are the requirements to use out-of-network benefits?
- Is prior authorization required?
- Is a referral required from my primary care physician>
- Do I have an out-of-network deductible? If Yes,
- What is my out-of-network deductible?
- How much of my out-of-network deductible has been met?
- What is the start date of the calendar year my out-of-network policy is based on?
- Is there a session limit? If yes,
What is the session limit?
- How many sessions do I have left?
- What percentage of services is covered/what is my co-insurance?
Ask the representative if your policy covers these services (CPT codes), what the usual and customary fee is for each code, and what percentage they cover after you have met your deductible.
|Service||CPT Code||Usual and Customary Fee||Percent Covered after Deductible is Met|
|Diagnostic Intake Interview:||90791|
|Individual therapy: 45 minutes||90834|
|Individual Therapy: Longer than 45 min.||90837|
Including testing, scoring, interpretation, and report writing (not all codes will be used but ask about each code to ensure your understanding of benefits
At the end of the call, make sure to have:
- Date/time you called:
- Representative’s name/ID#:
- Reference number for the call