Insurance

FEES

In 2022 our fees are:

$210 for intake sessions
$200 for couples and family sessions
$200 for individual sessions
$75 for group sessions
$400 for court appearances
$150 for IEP meetings

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 Employee Assistance Program (EAP), Oregon Health Plan (OHP), Medicare, or Medicaid.

IN-NETWORK benefits

We are in-network with Aetna, Cigna, Kaiser, MHN, MODA, PacificSource, and Providence.

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.”

If you have any billing questions, please contact Conner Gremillion (503-709-5137 x1 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?” (if it hasn’t been met, a follow up question is “How much is still left to meet before you start paying for my sessions at Brave Acorn?”)
If you have met deductible, “What is my co-pay for seeing an outpatient mental health therapist at Brave Acorn?”
“Are there any limitations on how many sessions I can see a therapist at Brave Acorn?”
“Do I have to get pre-authorized approval before I start therapy at Brave Acorn?”
“When is my renewal date?” (it’s usually January 1st of each calendar year, but on occasion it’s different; especially if you are a teacher)

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.