Pioneer Psychological Associates, LLC

 
Pioneer Psychological Associates, LLC
                                                                                                                                                                               
Daniel J. Wachtel, Psy.D.

        

Rates/Insurance:

My Professional Fees:

Fees are payable at the beginning or end of each session.  The fee for each 45-50 minute session is $175. The fee for the initial 60 minute diagnostic session is $200. Other fees include a prorated charge for any other professional service you may require outside of our sessions, such as report or letter writing, telephone conversations that last longer than 10 minutes, or preparation of records or treatment summaries.

 

Payment: 

Cash, check, and credit card are all accepted for payment for all fees and co-pays.  

 

Insurance:

I am an in-network provider for the following insurance plans:

Medicare 

Aetna

 

If you have an insurance plan that is not listed above:

I am not affiliated with any other insurance plans but my services may be reimbursed by many plans on an "out of network" basis. However, you, not your insurance company, are responsible for full payment of the fee. Therefore it is very important that you find out exactly what mental health services your insurance policy covers, and whether preauthorization or pre-certification is required. 

In order to find out how much your insurance will cover on an "out of network" basis, call the number on your insurance card and ask the service representative. I have included the directions below so that you know some of the important questions to ask your insurance provider in order to more easily pursue the reimbursement process. 

If your insurance plan covers mental health services, you would still pay my fee at the time of the appointment. I can give you a receipt for the session and you can submit the receipt to the insurance carrier. The insurance company will mail you a reimbursement check for a portion of the fee for each session, depending on the individual policy. 

What to ask your insurance Company:

If you ask the right questions and follow the right procedures, you can maximize the reimbursement that you will receive. The following is a useful guide to asking the right questions. 

1. Call the Member Services phone number on your insurance card. If your insurance company has a separate phone number for Mental Health or Behavioral Health, call that instead.

 2. Ask to speak with a representative (live person).

 3. Tell the representative that you would like information about Outpatient Mental Health benefits.

 4. Ask how you would find out whether Dr. Daniel Wachtel is a preferred or in-network provider.

 5. Ask the representative to explain your ?in-network? benefits AND your ?out-of-network? benefits.

 6. Be sure to ask about the following:

 

Deductibles (how much you have to pay before the insurance company will begin paying),

Co-pays (how much you will need to pay for each session),

Fee caps (some companies will only pay out up to a certain dollar amount whether or not that comes close to the going rate).

Session limits (some insurance companies limit the number of sessions they will cover per year).

Claims address (be sure to ask for the address where claims must be sent in order to get reimbursement).

Preauthorization requirements (ask whether preauthorization is required for outpatient mental health and what the process is for obtaining this. Also, are treatment plans necessary for continued treatment?).

Forms (what forms are required for filing and how can you obtain them?).

 

Insurance procedures can be very confusing. However, if you ask the right questions and follow the right steps, you may get your appropriate reimbursement.