Insurance

FEES

In 2022 our fees are:

$200 for intake sessions
$200 for couples and family sessions
$190 for individual sessions that are 53+ minutes long
$150 for individual session that are 38-52 minutes long
$120 for individual sessions that are 16-37 minutes long
$75 for group sessions
$400 for court appearances

Payments are typically made at the beginning of the month following the service provided unless you would like to make arrangements to pay after each session. Payment can be made by cash, check, debit card, credit card, or Health Savings Account (HSA) card.

INSURANCE

Cancellations must be made at least 24 hours in advance to avoid paying the full fee for the missed session (insurance companies do not pay for missed sessions, so the FULL fee would become your responsibility).

We do not take OHP, Medicare, or Medicaid.

IN-NETWORK benefits

Not everything people seek counseling for is covered by insurance companies. To utilize insurance to pay for your sessions, you must meet criteria for a diagnosable mental disorder whereby counseling is deemed “medically necessary.”

We are in-network with KAISER, but you will need to call KP Mental Health (503-249-3434) in order to get authorized to see us (otherwise Kaiser won’t pay for our services).

Kate Davis is still in the process of getting credentialed with Aetna, Kaiser, MHN, MODA, PacificSource and Providence (and can bill everyone except Kaiser as out-of-network until that credentialing process is completed).

Sarah Parnell is currently an in-network provider with:

Kaiser
MHN
MODA
she can also bill for “out of network benefits” if you have them
she is still in the process of getting credentialed with Aetna, PacificSource and Providence (and can bill for them out-of-network until that credentialing process is completed)

Kate Shaw is currently an in-network provider with:

Aetna
Kaiser
MHN
PacificSource
Providence
she can also bill for “out of network benefits” if you have them
she is still in the process of getting credentialed with MODA and can bill for them out-of-network until that credentialing process is completed

Emi Sakamoto is currently an in-network provider with:

Aetna
Kaiser
MHN
MODA
Providence
She can also bill for “out of network benefits” if you have them.
She is still in the process of getting credentialed with PacificSource and can bill them out-of-network until that credentialing process is completed

Katie Kotsovos, Bobby Messer, Bridget Redmon, Julio Iniguez, Melina Larkin, Valentina Pishchanskaya-Cayanan, and Sarah Alexander are all in-network with:

Aetna
Kaiser
MHN
MODA
PacificSource
Providence
They can also bill for “out of network benefits” if you have them.

If you have any billing questions, please contact Sarah Alexander (503-709-5137 x21 or [email protected])

OUT-OF-NETWORK benefits

If you have a different insurance provider than the ones listed above, services may be still be covered in full or in part by your health insurance or employee benefit plan if you have “out-of-network mental health benefits.” Please check your coverage carefully by calling up the member services phone number on the back of your insurance card and asking the following questions:

“Do I have mental or behavioral health benefits?”
“What is my deductible and has it been met?”
“Is Brave Acorn a preferred provider on my plan?”

If so:

“What is my co-pay for seeing a preferred provider?”
“How many sessions per calendar year does my plan cover?”
“Do I have to get pre-authorized approval before I start therapy?”
“When is my renewal date?”

If not:

“How much does my plan cover for an out-of-network provider?”
“what is my co-pay for seeing an out-of-network provider?”
“How many sessions per calendar year does my plan cover?”
“Do I have to be pre-authorized approval before I start therapy?”
“When is my renewal date?”

If your insurance company does provide “out-of-network mental health benefits,” let them know you will be seeing us (in case they require pre-authorization) and then you will pay us your portion of the fee with check, cash, or card at each session and we will bill your insurance company directly for their portion of the fee.

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that have NOT signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also are not required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: https://www.oregon.gov/blsw/Pages/index.aspx (if your therapist is an LCSW) or https://www.oregon.gov/oblpct/Pages/index.aspx (if your therapist is an LPC or LMFT).

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.

Why Some People Choose Not to Use Their Insurance for Mental Health Counseling

While using health insurance benefits allows you to save money in the short term, this benefit should be weighed against the risk of losing the confidentiality of your sessions. Health insurance companies require a mental health diagnosis in order to cover psychotherapy sessions. When you use your health insurance, your counseling sessions and confidential information (including your mental health diagnosis) become part of your permanent medical records. Insurance companies have the legal right to grant access to your medical records, and they often do. Some of the implications of this are as follows:

Insurance companies sometimes ask for detailed information to justify reimbursement for treatment that you may prefer to keep private. This information may include your diagnosis, symptoms, personal history, substance use, and summaries of your actual sessions.
These documents then become part of your medical record, which can be accessed by other insurance companies and have broad implications. For example, you should realize that if you are ever asked whether you have been treated for a psychiatric issue (for example, on a life insurance application), you will have to answer “yes” because your medical record will contain this information.
Insurance companies sometimes become very directive with healthcare providers, sometimes even dictating what questions are to be asked, along with a requirement to document the client’s responses.
You must have a diagnosable condition for a condition that matches a description in the DSM5 whereby counseling is deemed “medically necessary” to use insurance (i.e. not everything you want to seek counseling for is necessarily covered). And, again, this diagnosis must be reported to your insurance company and becomes part of your record.
Optimal care sometimes requires more sessions than allowed by insurance companies. Occasionally only a certain number of sessions are covered, regardless of your actual need.