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Koala Smiles Counseling

RATES AND PAYMENTS

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Shawnda's Rates:

 

Shawnda's standard fee is $150 per 50 minute session

 

Initial Assessment / Intake fee is $175 per 60-90 minute session

Due to the amount of paperwork and information gathering required to set you up as a new client my fee for the first session is higher than all other sessions. After the first session, my standard fee applies.

 

Sliding Scale: Reduced fee services are available on a limited basis (only private pay clients)

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Insurance:

 

  • Shawnda does not bill insurance for couples therapy because most insurance companies do not cover this service. Feel free to email her at shawnda@koalasmiles.com if you’d like an explanation for this.

 

Shawnda is a preferred provider for and accept the following insurance plans (please be sure to double check with your insurance company to be sure she is in network for you, some policies have different tiers that might be considered out of network):

 

Blue Cross / Blue Shield

Bridgespan Health

Cigna & Cigna EAP

First Choice Health Network PPO

Kaiser Permanente / Group Health (Options PPO, Omni PPO and Access PPO)

Healthcare Management Administrators (HMA)

LifeWise

Premera Blue Cross

Regence BlueShield

Uniform

Trust Funds (case by case basis, please have your trustee contact me)

 

Shawnda is an out of network provider for all other insurance companies

 

If your company is not on this list and you have out of network benefits, She can still bill your insurance, however, your patient responsibility is typically a higher percentage. It is up to you to obtain any mental health pre-authorizations (if required by your plan) and know your benefits prior to your first visit.

 

Insurance/Managed Care Billing:

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If Shawnda is billing your insurance, your copayment is required at the time of service. If your insurance coverage requires you to pay a co-insurance, you may either pay at the time of service or you will be billed after insurance has paid. She will bill insurance companies directly, unless you request otherwise, and will provide you with a monthly statement for any outstanding balances. Unpaid balances more than 90 days past due will be charged an 18% interest rate (1.5% monthly). Accounts more than 180 days past due will be referred to collections. Any collection legal fees or costs necessary to collect an unpaid balance will be your responsibility.

It is your responsibility to follow any plan requirement that applies to you including co-pay amounts, co-insurance and deductibles. It is recommended you clarify with your insurance company the specific benefits provided under your insurance plan and to follow any plan requirements that apply to you. For example, some plans require that you obtain an authorization/referral from your insurance/managed care company prior to your first session. Most plans limit the services for which they will reimburse. If you request or agree to a service for which reimbursement is later denied by your insurance company or its agent (i.e. not pre-authorized, considered medically unnecessary, beyond the benefit limit, etc.) then you assume the responsibility for paying the entire fee.

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Payment Methods:

 

Cash, Check, Money Order, Health Savings Account, Debit/Credit Card (Visa, Mastercard, Discover, American Express) or Paypal.

 

Out of Network Clients (private pay)

 

At Koala Smiles Counseling, PLLC, I understand that finances can be a real concern for those who seek the help of a counselor. Upon paying for your session, I will provide you with a receipt. You can then present this receipt to your insurance company for reimbursement. Most often, companies will provide reimbursement based on your specific reimbursement rate for out-of-network care. Usually, the amount returned is calculated as a percentage, so if you have financial concerns please check with your agency to learn more about its particular policies. You have a right to request a good faith estimate from me at any time. 

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