Insurance FAQs

Getting Started with Counseling

I offer a complementary 10-minute initial phone consultation to make sure that we are a good fit.  I’ll ask about your current situation and your goals. We can discuss my approaches to therapy, appointment times and fees. This consultation is not a therapy session. If we are not a good match, I’ll do my best to refer you to someone who can help you.

I do not see clients who are suicidal, have a diagnosis of borderline personality disorder, or where there is current domestic violence, or where substance abuse is the primary issue.

Click here to read about my specialties.

There is a 48-hour cancellation policy to avoid a full charge fee. If you need to reschedule, tell me as soon as possible so your time slot can be made available to another client. This is especially important for evening appointments where the demand is high. Thank you in advance for being conscientious.

Fees: Please contact me to ask about self-pay fees. A sliding scale is available on a limited basis.

INSURANCE
I get a lot of questions about insurance, so here’s the information you’ll need.

Q: What if I miss an appointment and I don’t give a 48 hours cancellation notice?

A: Insurance does not reimburse me for broken appointments so you are responsible for the full allowable fee by the insurance company. The fee must be paid before the next visit, or upon receipt of a bill, whichever comes first.

I confirm appointments 1-3 days ahead of time to help prevent missed appointments. If we can reschedule within the same week (Monday-Thursday), you won’t be charged for the missed session.

Q: How much will therapy cost if I have insurance?
A: The amount you will pay is determined by the allowable rate by the insurance company. Call the member services phone number on the back of your insurance card (it might say mental health or MH/SA).

Ask your insurance company the following questions and let me know what they say.

Is distance counseling – tele mental health – allowed?

The co-pay for medical and mental health services maybe different, so ask specifically about mental health benefits. I am considered a mental health specialist.

What is the allowable rate for outpatient mental health office visits for 53 minutes? CPT codes 90791 and 90837
What is my deductible?
How much of my deductible have I met?
What is my co-pay and/or coinsurance after the deductible is met?
Is authorization required?
Is there a limit on visits?
When does of the insurance policy reset for the year?
Is the co-pay for medical and mental health combined?

If you don’t call for your benefits and don’t know your coverage, we will estimate your portion of the fee based on our prior experience. If the allowable fee turns out to be different when we get the “explanation of benefits” (EOB) from the insurance company, we will make appropriate adjustments. That is, we will credit your account, or we will ask you to pay your balance. It take two weeks to two months to get the EOB.

I highly recommend that you call your insurance company to research your benefits.

Q: What insurance companies do you use?
A: I process all BlueCross BlueShield (BCBS) plans. I am out of network with all other insurance companies.

Note: Sometimes BCBS contracts with other insurance companies, and I may not be on those panels. Ask BCBS if your plan is subcontracted out.

Q: What if I don’t have BlueCross BlueShield?
A: If you have another insurance company and you have “out of network benefits,” we can process claims for you. Call your member services phone number and ask all the questions above. I can give you a receipt to turn into your insurance company for reimbursement.

Q: What if I have a Health Savings Account?

A: I can give you a receipt to turn into your company for reimbursement.

Tip: Call your insurance company when they first open in the morning to avoid a long hold time.

Special Notes:

To use insurance, I must assign a mental illness diagnosis, e.g., anxiety, depression, PTSD, or adjustment disorder. If you do not want a mental illness diagnosis on your record, you’ll want to pay out-of-pocket.

I am not a provider for Medicare or Medicaid.

Got More Questions?

Please complete the contact form.

I look forward to hearing from you soon.

Benita A. Esposito, MA, LPC, LCMHC

Licensed in Georgia and North Carolina, USA

Psychotherapy to foreign countries may be a possibility. Let’s talk about it.