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Payment / Insurance
All payments are due at time of service unless other arrangements are made in advance.
We bill most insurance plans, though please note if you have a managed care plan, we very probably do not participate. You are responsible for copayments, deductibles, or amounts not covered by insurance.
We now take Visa, Mastercard and American Express.
We were Blue Cross Blue Shield PPO and Blue Options Providers for many years. BCBS terminated all mental health provider contracts with them effective Nov. 30, 2011. We told them where to go with their proposed New Directions contract. See: Our letter informing BCBS patients of our termination (.pdf)
We do see Worker's Compensation cases with proper prior authorization.
We did accept Medicare one upon a time. In all likelyhood the Medicare system will be gutted. Reimbursement for neuropsych testing under medicare is about 30% of our usual rates and is scheduled for regular reductions every year for the next few years. We are considering totally opting out of Medicare.
Accident Cases: Due to changes made in 2008 to the Florida Auto Insurance System we no longer see accident cases under their auto insurance without prior arrangements through your attorney. Due to the litigation involved and the changes in the system, we only will perform eveluations in accident cases if requested by your insurer as a psychological or neuropsychological Independent Medical Examination or if we are directly retained and paid by your attorney as an expert. We believe this best protects all parties
Most insurance companies do not cover marital therapy. Billing for marital therapy as individual therapy is fraudulent, so if your plan does not cover it, don't ask us to do so. We encourage private payment for marital therapy to maximize confidentiality.
Learning Disabilty, Academic or IQ Testing While insurance may cover some psychological testing, most does not allow billing of testing for intelligence testing, learning disability or academic testing. Blue Cross Blue Shield issued a letter instructing providers not to bill for academic, learning disability or IQ testing, so please do not ask us to provide a CPT code to bill the insurance for that. We will not. Since your insurance does not cover it and precludes us submitting this to them, we do not bill them for it and it will not appear on your insurance Explanation of Benefits. You will be billed and must pay our full fees for the time in administrating, scoring, interpreting the educational and/or intellectual portions of our testing. We will bill and provide CPT codes for services that are considered medically necessary under BCBS or other plans.
Alcohol and drug treatment benefits may be more limited in some plans than other mental health benefits. This should improve under some plans in future years due to mental health parity legislation.
We cannot take or bill Medicaid.
We DO NOT take Health Options, Humana, Magellan, United Behavioral, or AvMed. Effective Dec. 1 we also will not take New Directions. Nor at this point do we ever wish to. Independent providers may take some of these plans, check with your insurance. If you have one of these managed care plans, you may choose to pay privately for services.
WE are NOT UNITED HEALTH CARE providers. We will not sign any form of contract with them. If you are a United insured, you may pay us privately and we will give you the information you need to bill your own insurance.
Since plans and participation constantly change, please call your insurance plan to determine if Clinical Psychology Associates of North Central Florida. or any of our specific providers are currently covered by your insurance plan.
FAQ: Okay, Okay, your not on my plan, but will you "take" my insurance?
Generally, if you do not have a HMO or managed care plan, and you have out-of-plan mental health benefits your insurance should cover some part of our services. If we are not a participating provider, you will be responsible for payment at time of service. We will give you the information in term of diagnosis and procedure codes to try to wrestle what you can from your insurance company.
FAQ: Okay, just what are your usual fees?
City of Gainesville Employees are entitled to three visits. Usual fees are $275 for the intial hour of intake, $160-$180 per hour for therapy, $180 per hour for review of records, $250 per hour for testing, scoring time, interpretation time and report writing time.
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TIMES ARE TOUGH - DONATIONS TO HELP SUPPORT OUR EDUCATIONAL WEBSITES or THE PRACTICE ARE NOT TAX-DEDUCTIBLE but ACCEPTED THROUGH PAYPAL address: cpancf@aol.com
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