Fees and Appointments

Most health insurance plans provide some form of coverage for psychological services. Determination of coverage is best obtained with a phone call to your insurance company. There are two forms of coverage: In-Network and Out-of-Network. In-network benefits cover some psychological services with clinicians who sign contracts with the insurance company to provide services at a set rate. With these benefits, the insurance company oversees the treatment, authorizing the number of sessions allowed for a particular condition. Depending on your plan, your total number of sessions may be limited within a calendar year. Out-of-network benefits cover psychological services with a clinician of your choice. Most plans require the patient to pay a deductible, and then reimburse a certain percentage of the fee after that, typically 75 or 80%. Some of these plans limit the number of sessions or the dollar amount that are reimbursable each year. The psychological services are not managed and authorization is not required.

Dr. Kot participates as an In-Network provider for Horizon Blue Cross/ Blue Shield PPO, Aetna, and Medicare. He is out-of-network for all other insurance plans. Fee information and payment arrangements are discussed at the initial evaluation. Ultimately, the patient is responsible for all payment regardless of insurance reimbursement.

To ensure patient confidentiality and decisions about treatment such as the frequency (if more than one session per week is needed) or duration (for how long you can remain in therapy), out-of-network benefits or out-of-pocket payment is best. Insurance companies require regular treatment plans to be submitted by their network providers in order to continue authorizing sessions. Some patients feel uncomfortable sharing any personal information with anyone other than their clinician to whom they have entrusted their confidentiality. Financially, on occasion, there could be a miscommunication or error on the part of the insurance company which may result in a reduced or lack of coverage leaving the patient with large, unexpected bills. For better control over YOUR treatment and YOUR confidentiality, you may wish to consider out-of-network benefits or out-of-pocket payment. Regardless of what method of payment you choose, assistance is provided with obtaining reimbursement from insurance companies.

An initial evaluation is $175 and is generally 45 minutes in length. Fee for individual therapy is $150 for a 45 minute session. Cancelled initial evaluation and individual therapy sessions without at least 24 hours notice will result in a full session fee. Testing and assessment is $175 per hour, including scoring, report writing, and feedback. All testing and assessment requires a 50% down payment for all services to be rendered prior to the initiation of testing. Scoring and report writing typically equals the total time of face-to-face test administration and is charged separately along with a one hour feedback session to explain test results. Cancelled testing and assessment sessions without 24 hours notice will result in a one hour ($175) cancellation fee.

Payment

Payment for services is expected at each session or monthly as arranged with Dr. Kot. Regardless of insurance status, the patient is ultimately responsible for all professional services rendered.