The No Surprises Act
In accordance with the No Surprises Act taking effect on Jan 1st 2022, we are now required to provide a “good faith estimate” of the expected charges in advance of scheduled services (or upon request) to uninsured (or self-pay) individuals. We have always had good communication with our clients about costs and fees, and any confusion related to billing is usually cleared up within hours. The new rules detailed in the No Surprises Act simply formalizes the processes of providing an estimate of costs, as well as the process for resolving any disputed charges.
To read more about your right to obtain a “good faith estimate,” click here.
If you have insurance that we are not in-network with (we are only in-network with BCBS PPO) we are required to ask you if you intend to submit out-of-network reimbursement claims to your insurance company. This is something we have always encouraged all of our out-of-network clients to look into; the new law simply requires we ask you if you intend to submit claims for out-of-network reimbursement and provide you with an estimate of your bills. If you do plan to submit claims for out-of-network reimbursement (do check if your insurance plan allows it first) let us know and we will provide you with a “superbill” that has all the information your insurance company will need. The law also requires us to not charge you more for services than we would charge an in-network client (a practice that we have never engaged in).
OUT-OF-NETWORK ESTIMATE FOR PSYCHOTHERAPY:
Estimates are provided and electronically signed through our software portal and are securely stored as part of your medical record. Scheduling an initial appointment automatically triggers a written good-faith estimate to be sent to you and stored in our system for all out-of-network/self-pay clients. You can also request that a good faith estimate be sent to you anytime by emailing logansquarecounseling@gmail.com.
Although all out-of-network/self-pay clients will receive their own personal Good Faith Estimate, in the interest of transparency we will also provide a general estimate of our out-of-network/self-pay fees below, which contains much of the same information.
The (maximum, upper end) estimate of your out-of-network/out-of-pocket charges is as follows:
For therapy sessions with psychologists (doctoral-level therapists), your out-of-network cost will be $159.09 per session. Because it is difficult to estimate the necessary length of treatment (especially before getting to know you) we estimate the length of treatment to be 50 weeks for a total cost of $7954.50. Please note you and your therapist may agree to a fee that is lower than the $159.09 insurance fee. We will not charge you an out-of-network rate that is higher than our $159.09 insurance fee for work with a psychologist.
For therapy sessions with a counselor or social worker (masters-level therapists), your out-of-network cost will be $132.01 per session. Because it is difficult to estimate the necessary length of treatment (especially before getting to know you) we estimate the length of treatment to be 50 weeks for a total cost of $6600.50. Please note we will not charge you an out-of-network rate that is higher than our $132.02 insurance fee for work with a counselor.
The service we provide is Individual Psychotherapy in an Office setting, denoted by the CTP code 90837. The expected charge for this service is $159.09 for work with a psychologist (doctoral-level therapist) and $132.02 for work with a counselor or social worker (a master’s level therapist). Please note we will not charge you an out-of-network rate that is higher than our $132.02 insurance fee for appointments with a counselor or social worker. In some cases, some of our clients may given a lower rate, never a higher rate than our in-network insurance rate.
A bill used for out-of-network insurance reimbursement also includes a diagnosis. However, because diagnoses are deferred until more information is gathered about you and your symptoms (often after one or two sessions) we are unable to provide you with a diagnosis at the time of an estimate/before treatment has started. Please note that as long as a diagnosis is considered by the insurance company to be “covered” there is no variability in the reimbursement rate based on one behavioral health diagnosis to another; all covered behavioral health diagnoses are billed at the same fee.
In Summary:
Estimated Fee (psychologist) $159.09
Estimated Fee (psychologist) $132.02
CTP Service Code: 90837
Estimated length of treatment 50 weeks.
Logan Square Counseling LLC
NPI number 1386097186
3448 W Diversey Ave
Chicago, IL 60647
Disclaimers:
These are estimated costs related to your treatment. The vast majority of people in therapy attend weekly, however in rare cases it may be recommended (not required) that you attend twice weekly. In this event, your costs would increase proportionately. Actual charges may differ from the Estimate. In the course of your treatment, your therapist may recommend additional services (additional therapy sessions, psychiatry, group therapy, dietician services, primary care visits, etc). Costs associated with these additional services are not included in the above estimate. This good faith estimate is not a contract and does not obligate you to obtain services. You enter into therapy on your own volition and may leave treatment at any time.
If you receive charges that are substantially more than your estimate you may initiate a dispute resolution process. You may find more information about the dispute resolution process here.
https://www.cms.gov/nosurprises/consumer-protections/Payment-disagreements
For In-Network clients with BCBS PPO insurance
The information above is primarily an estimate for out-of-network clients. If you have BCBS PPO insurance we are happy to provide you with an estimate of your copay (flat fee) or coinsurance (percentage) amount. We have always done our best to provide this information before scheduling an initial appointment, and we will continue to do so. We have likely already provided you with that information, but if you need any clarification or want a formal written estimate of your fees based on your in-network BCBS insurance coverage, feel free to email us at logansquarecounseling@gmail.com and we will be happy to provide that for you. Please note that if your insurance plan changes your costs may change as well. There are also times that BCBS tells us the wrong information about your coverage/costs (this is rare, but it does happen). In these cases, you may owe more than the estimate. We always encourage clients to verify their coverage with BCBS directly.
Please direct any questions related to this document to logansquarecounseling@gmail.com
More about your right to obtain a Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost
Under the law, healthcare 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 healthcare 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 or call or 1-877 527-9431 or our office at 773 245-3725.
psychotherapy
Our first priority when working with people is to create a comfortable, safe, and confidential space to share and discuss whatever you like. Our approach is to help you to be more effective in your personality and more comfortable in your own skin. Many people come to therapy with the idea that they would like to be a different person. Although there are of course patterns and aspects of your life that can be changed, the goal of treatment is often to accept and understand who you are and who you are becoming as you make instrumental choices in your life. A talented therapist can discern the essential strengths of your personality from your troublesome habits and patterns, and can help you to experience the uncertainty of life with a greater degree of confidence and understanding. We are able to work with people who have a variety of difficulties including depression, low self-regard, anxiety/social anxiety, phobias, relationship difficulties, anger management problems, substance abuse and dependency, eating disorders and body image issues, and obsessive compulsive tendencies. We are particularly adept at helping those who are curious, creative, and individualistic thinkers. We understand that you and your difficulties do not exist in a vacuum, and that the social context of your environment and your personal experiences must be considered to truly understand and help you.
Anxiety
Anxiety is a part of life. We all experience some fears and worries about how we are doing, where we are going, and how we are perceived by others. But for some of us the feeling of anxiety becomes overwhelming and oppressive, and as a result we begin to avoid the things in life that are good for us. Therapy can teach skills that reduce the experience of anxiety, and help you grow into a more comfortable, confident, less avoidant, and more adaptable version of yourself.
Depression
Most people will experience some period of significant depression within their lifetime. For some it manifests as negative thinking, seeing every challenge as a problem, every setback as a failure. For others depression is experienced in the body, as loss of energy, focus, and even physical discomfort or pain. Many of us tend to hide this discomfort, both from ourselves and from others, feeling embarrassed, ashamed, or weak. Therapy can help you to learn the skills of keeping yourself open to both joy and sadness without becoming overburdened by your emotions. While some sadness is inevitable in life, depression is not.
relationships
Relationships between people are the most complex, meaningful, and often most difficult parts of our lives. Being close to another person can bring immense joy, or a deep sorrow; most commonly, it is some combination of the two. While it is sometimes helpful to provide treatment to a couple or family, it is also not uncommon for people to work on their intimacy and relationship patterns in individual therapy as well. We are able to help clarify issues, to teach effective communication, problem solve, and to provide guidance for alleviating stressors in relationships.
Work
Another common stressor in our lives is our work. We often find ourselves dedicating more time and energy to work activities than we would like to, and many of us have trouble finding meaning in our day to day lives as a result. Therapy can help to uncover or modify your pathway through life and direct you towards more meaningful work, a more balanced life, and an increased freedom to make choices about your career.
INSURANCE
We are In-Network with Blue Cross and Blue Shield of Illinois. We accept traditional BCBS PPO insurance, as well as the BCBS "Bluechoice" PPO (Marketplace/"Obamacare") policies. We do not accept BCBS HMO insurance. If you are unsure about your specific coverage feel free to reach out; for most policies we can easily check on your coverage and let you know before scheduling a first appointment.
Most people with BCBS PPO insurance have a $20 or $30 copay, and insurance covers the rest of the cost. Some people do have deductibles, but for most people the deductible only matters when treatment is at a hospital (inpatient), not at an office (outpatient). In most cases, whatever your pay when you go see your regular primary care physician is what you also pay when you go to outpatient psychotherapy.
For more detailed information about insurance or billing click below for our FAQ section.