Insurance
Self-Pay Process
Gentle Journey Play Therapy is a private pay practice. We are not in-network with insurance companies but accept PPO insurance as out-of-network providers. That means you pay your therapist directly after each session and then we provide you with a receipt for services (called a superbill) for you to submit to your insurance at the end of every month. If your claim is accepted, your insurance will mail you a check for the amount they agree to reimburse or they will apply that amount to your deductible depending on if you have hit your deductible for the year yet. We value the privacy of our clients and have chosen not to participate in insurance panels. In doing this, we are not required to provide diagnostic codes that could affect children’s future opportunities.
When navigating insurance coverage for therapy, especially with out-of-network providers, asking the right questions can help you understand your benefits and manage costs effectively. Here are some important questions to consider:
What is my insurance's maximum allowable rate for an out-of-network provider?
If your insurance plan includes out-of-network coverage, your therapist can provide documentation (using an ICD-10 code that indicates a diagnosis is being deferred) to reimburse session fees.
Is there a deductible that needs to be met before you reimburse for out-of-network therapy sessions?
If so, ask what the deductible amount is and how close you are to meeting it.
Is there a limit to how many therapy sessions you will reimburse for?
Understanding any session limits can help you plan accordingly.
Can I use my Health Savings Account (HSA) or Flexible Spending Account (FSA) to cover therapy costs?
These accounts allow you to pay for therapy with pre-tax dollars, which can be a cost-saving option.
By clarifying these details with your insurance provider, you can ensure that you understand your financial responsibilities and make informed decisions about accessing therapy services.
Payment is required at the time of treatment. We accept cash or credit cards.
Please call your insurance company to confirm your out-of-network reimbursement percentage before scheduling the free consultation.
Medicaid (Care Source, Peach State, Amerigroup, etc.)
Because we are a private-pay practice, we cannot treat children on any Medicaid plans.
Please call your Medicaid provider and request a list of approved mental health providers who are in your network.
NO SURPRISE ACT NOTICE
YOUR RIGHT TO A “GOOD FAITH ESTIMATE”
You have the right to receive a ‘Good Faith Estimate’ explaining how much your medical care may cost.
Under the law, healthcare providers must give patients who do not have insurance or are not using insurance a cost 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 costs related to medical tests, drugs, equipment, and hospital fees.
Your healthcare provider must give you a ‘Good Faith Estimate’ in writing for scheduled services within designated timeframes. You can also ask your healthcare provider 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 1-800-MEDICARE (1-800-633-4227).