Insurance

FEES

In 2024 our fees are:

$210 for intake sessions
$200 for couples and family sessions
$200 for individual sessions
$75 for group sessions
$1,000 for court appearances
$150 for IEP meetings

Payments are typically made the week 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.

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).

If you have any billing questions, please contact Conner Gremillion (503-709-5137 x1 or [email protected]).

INSURANCE

We do not take Employee Assistance Program (EAP), Oregon Health Plan (OHP), or Medicaid.

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 health disorder whereby counseling is deemed “medically necessary.” In the case of mental health therapy, medical necessity means that you meet criteria for a DSM-5-TR diagnosis such as adjustment disorder, generalized anxiety disorder, persistent depressive disorder, eating disorders, or post-traumatic stress disorder (to name a few of the ones that are commonly treated at Brave Acorn).

IN-NETWORK benefits

Brave Acorn accepts and processes in-network insurance payments through a variety of insurance providers. At this time, we are in-network with Aetna, Kaiser Permanente (commercial plans, not OHP), MODA, PacificSource (commercial plans, not OHP), and Providence. If you are using an in-network insurance plan to pay for our services, then we will:

1. Expect and accept payment of your copayment, co-insurance, deductible, or fee difference amount within a week after services are rendered.

2. File your claim with your insurance provider.

3. Receive payment from your insurance provider.

Brave Acorn files in-network insurance claims as a courtesy to you, and you (not your insurance company) are ultimately responsible for your bill. For this reason, we highly recommend that you check with your insurance company to verify your own in-network outpatient mental health benefits.

OUT-OF-NETWORK benefits

Brave Acorn also works with clients who have other insurance plans (except OHP) on an out-of-network basis. Not all plans offer out of network benefits, however. If you are uncertain about whether you have out-of-network benefits or not, we highly recommend that you contact your insurance company directly to inquire. If you are using out-of-network benefits to reimburse for our services, then we will:

1. Expect and accept payment of our full standard individual diagnostic/assessment fee or our full standard individual counseling fee within a week after such services are rendered.

2. Provide you with a superbill as soon as payment for that service is provided, so you may choose whether or not to submit it yourself to your insurance provider in order to seek reimbursement directly from them.

3. If you choose to submit that superbill to your insurance provider, they will reimburse you for that service according to your plan contract with them. In the case that you are not reimbursed at the rate that you think you should be, you will need to work directly with them (rather than Brave Acorn, LLC) to understand the discrepancy.

Brave Acorn accepts out-of-network insurance plans and provides you with a superbill as a courtesy to you, and you (not your insurance company) are ultimately responsible for your bill. For this reason, we highly recommend you check with your insurance company to verify your own out-of-network outpatient mental health benefits.

PRIVATE PAY

If you opt NOT to use insurance, you will self-pay for services at Brave Acorn and payment is due within a week of services. Brave Acorn will not file a claim for services through insurance nor will Brave Acorn provide a superbill for you to submit to an insurance company for reimbursement. If you opt for private pay and your household income to dependents ratio is such that you qualify for our sliding fee scale, that may be discussed with Sarah Alexander (owner of Brave Acorn). Whether you pay our full fee or qualify for our sliding fee scale, you will be provided with a Good Faith Estimate clearly outlining your financial responsibility for receiving services at Brave Acorn.

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.