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Payment / Insurance

All payments are due at time of service unless other arrangements are made in advance.

Our aim is to provide quality, independent services.  We will provide you with a "superbill" with the necessary information your insurance company requires for reimbursement of any plan or out-of-plan benefits.  City of Gainesville employees benefit from three free visits for themselves, spouses, domestic partners, or dependents. City of Gainesville employees with City insurance and covered family members including GPD officers and GFR employees are eligible for additional sessions for a $25.00 co-pay. Insurance is not billed but the City provides further compensation to us under the City contract.

FAQ: Okay, Okay, you are 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 or may 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. Higher deductible and co-pays for out-of-network providers is common.

FAQ:  Okay, just what are your usual fees?

City of Gainesville Employees are entitled to three visits.  Usual fees are $325 for the initial hour of intake, $200 per hour for therapy, $200 per hour for review of records. Higher fees apply per hour for testing, scoring time, interpretation time and report writing time.

After many successive years of health care deform, we no longer bill insurance plans.  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 did accept Medicare one upon a time. Reimbursement for neuropsychological testing under Medicare is less than 30% of our usual rates for the rather comprehensive evaluations we perform. We are not participating providers with Medicare but have not opted out of Medicare which means we cannot see or private-bill Medicare patients except for forensic or administrative evaluations which are not covered by Medicare and you would need to private-pay for. 

We don't take Medicare Advantage. Lots of providers don't for good reason. Get rid of it. Stick with regular Medicare plans.

We take Visa, Mastercard and American Express.

We do see Worker's Compensation cases with proper prior authorization.

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 evaluations in accident cases if requested by your insurer as a psychological or neuropsychological Independent Medical Examinations, Compulsive Medical Exams, or if we are directly retained and paid by your attorney as an expert.  We believe this best protects all parties.

Learning Disability, 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.  to mental health parity legislation. 


We cannot take or bill Medicaid.

We DO NOT take Health Options, Humana, Magellan, United Behavioral, or AvMed.  We also do 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.

 

 

 

 
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Gainesville Office: 2121 NW 40th Terr. Ste B. Gainesville, FL 32605  -   Phone: (352) 336-2888  -   Fax: (352) 371-1730
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