What to Expect and Insurance Information
On Your First Visit
We look forward to welcoming you to your visit! When you arrive, just have a seat in the waiting area or seamlessly click on your telehealth link, and we will promptly meet you at our scheduled appointment time.
Usually, the first visit is called an Intake (first hour-long session). At our first counseling appointment, we will get the paperwork filled out and get a more detailed history from you concerning the struggles we’ll be tackling together. We want to be able to meet comfortably and have a chance to get to know each other before we really begin our therapeutic relationship. This is a perfect chance for you to get to know our counseling approach and to ask any questions you might have about us as therapists, how counseling and psychotherapy work, or any other questions that you might have. Of course, we’ll ask about your history, background and current needs so we know what you need help with and a plan for moving forward. With a few questions and a little history, we’ll be off to a great start and we’ll be able to give you some initial ideas about how we will be able to work together. Hopefully, you’ll take this as an opportunity to decide if we are going to be a good fit for you. It’s vital that you find a therapist that you are comfortable with, so please don’t feel any pressure one way or another. Your care is what’s most important to the both of us.
At this point, if you decide that moving forward with therapy is a good choice for you, we will gladly schedule you for following appointments.
The Therapeutic Process
We think that therapy is a team effort and it will take both of us working together to accomplish your goals. After all, we are the experts on human behavior and psychotherapy but you are the world’s only expert on you. We will depend on each other’s knowledge and expertise. We’ll ask you to bring your history and knowledge of yourself to our counseling discussions and know that, at times, it will be a hard task for you. Sometimes you will face discomfort as you to talk about your experiences honestly, but we know that if we work together we can help you grow in the best direction for your life. We promise to work just as hard and be just as honest with you as you are with us.
We will be asking you questions about what’s going on in your present situation and what has happened in the past as we move forward. The purpose of the questions is to prompt honest, introspective answers which will allow us to look into your current motivations and needs. Sometimes, there will be homework so you can continue to grow when we are not in a therapy session. If you find that you like the homework as a complementary addition to your therapy, just let us know! We take your preferences into account when prioritizing our approach.
Our goal will always be to encourage growth and change which will let you feel more comfortable and productive in your own life. You should be able to lay down any burdens that are holding you back from this and making life harder on you. Hopefully, this sounds like a goal you’re willing to work for and are excited about reaching. It will be hard to reach, you should know. Change doesn’t come easily to most people and it can be very uncomfortable. Real, healthy change takes a lot of work, but it’s worth every ounce of work you put into it!
When You Are Ready to Wrap Up
Once you feel like you have reached your goal and you’ve achieved the changes you were striving for, we like to make sure that you have a chance to wrap up the work we’ve done and that you have everything you need from therapy, including a sense of closure and a plan to move forward. We will refer to the last session as the “termination session.” While parting is always bittersweet, this is a beautiful time of reflection where we can look at how all of your hard work will help you accomplish goals in the future.
The termination session will be scheduled when you and your therapist decide that you are ready and feel like you’ve accomplished your current goals. We will be able to celebrate your success, review your journey and turn our attention towards your future endeavors. When you leave your termination session, you’ll walk away with a summary of your goals, achievements, approaches and tools which worked for you, and your future goal statements. It’s our sincere hope that you will use this information to help you on your continued work to change and grow for the better. The termination session is one of the best parts of our job as it is a chance to congratulate you on your hard-earned success!
Insurance and Payment
- UnitedHealth care
-Colorado Community Health Alliance (Services: Park, Teller, El Paso, Weld, and Northwestern Colorado Counties)
-Colorado Access (Services: Denver, Adams, Arapahoe, Broomfield, Douglas, and Elbert Counties)
-Rocky Mountain Health Plans (Western slope Colorado Counties)
Most therapy is covered by insurance – depending on the plan – any copays, coinsurances, or deductibles that are owed by the patient, are expected at the time of service.
While we are happy to verify eligibility and benefits before your first session, please know it is not a guarantee of payment by insurance. Anything billed to and not covered by insurance will be the responsibility of the patient.
Key Insurance Terminology:
- Negotiated Service Charge – the total amount due for the service rendered that is considered a covered service by insurance. Typically, the rate the provider charges(their direct/cash rate) minus what insurance will pay for a service.
-Example: If a provider charges $150.00 for an hour session, but the insurance they are contracted with will only pay $101.50 for that service, then the combined payment from the insurance and the patient, will not exceed the $101.50 negotiated service charge; the remaining $48.50 from the direct rate ($150.00-$101.50) is often referred to as the “Provider Discount” or “Contractual Difference” which is written off by the provider for that service.
- Deductible – the amount owed by a patient before insurance covers a portion of the negotiated service charge.
-Example: Having a $2000.00 deductible means a patient is responsible for the full negotiated service charge until they have paid $2000.00 worth of services. Thus, if the negotiated service charge is $101.50, then the patient will pay the full $101.50 until their deductible amount is met. Typically, once a deductible is met, the patient will owe a co-insurance amount; on rare occasions, they will pay a copay.
- Co-insurance – a percentage amount of the negotiated service charge owed by a patient, while insurance covers the remaining percentage amount.
-Example: If a patient has a 20% co-insurance, and the negotiated service charge is $101.50, the patient will pay $20.30 (20% of 101.50), and the insurance will pay the remaining $81.20 (80% of 101.50) due to the provider for the negotiated service charge.
*Co-insurance amounts due (not the percentage amount) will differ based on services rendered, such as a 60-minute session vs a 45-minute session because the negotiated service charge will differ for those services.
- Copay – the flat rate (determined by insurance) a patient will pay until their out-of-pocket maximum is paid in full.
-Example: If a patient has a $25 copay, and the negotiated service charge is $101.50, the patient will only pay the $25 copay and insurance will cover the remaining $76.50. The patient will always pay the same copay amount until their out-of-pocket maximum is met regardless of the services rendered.
*Copays do not apply towards a deductible.
- Out-of-Pocket Maximum – the full amount owed by a patient during the benefit year (typically (not always), January through December) before insurance will pay the full cost of all covered services.
-Example: If a patient has a $4000.00 out-of-pocket maximum and has paid for services that accumulate to $4000.00 paid to providers, then the patient will no longer have a portion to pay for services rendered for the remainder of the benefit year of attended services.
There are a few ways for an out-of-pocket maximum to be met – again dependent on the insurance plan.
- Some allow the amount paid towards the deductible to also apply to the out-of-pocket maximum, e.g. if a patient has paid $1000.00 towards their deductible, this would mean they have also accumulated $1000.00 towards their out-of-pocket maximum at the same time.
- Other insurance plans require that the deductible be met in full before the patient starts accumulating toward their out-of-pocket maximum. Meaning if they have paid $2000.00 for services meeting their deductible amount, but their out-of-pocket maximum is $4000.00, they will still need to pay $4000.00 more until the covered services are paid 100% by insurance at no further cost to the patient.
- Both coinsurance and copays always accumulate towards the out-of-pocket maximum and not the deductible.