Elizabeth Gessel, MFT

Insurance

Insurance coverage can be confusing so I've included a brief description of standard insurance plans and how they work.

HMO (Health Maintenance Organization): These are plans in which your primary care physician makes your referrals. You pay a copayment for each visit.

PPO (Preferred Provider Organizations): In these plans you may self refer to any provider as long as they are on your medical plan’s approved panel. You pay a copayment for services.

Indemnity Plan: This plan allows you to see any provider of your choice. You usually pay the full fee at the time of service and submit claims until a deductible is met. Once a deductible is met then you are reimbursed a percentage of fees paid.

POS (Point of Service Plan): These plans combine an indemnity plan with an HMO or PPO plan. Your fee is based on the point of service/provider you see. If you seek care in-network, you pay HMO/PPO copays. If you go out-of-network, you pay indemnity rates. 

Mental Health Plans: Many health care plans have mental health carve outs--separate benefit plans with their own set of rules regarding providers, copayments, and visit limitations. That’s why it’s so important to check with your plan to make sure you know what's covered.

Something to consider...

FSA (Flexible Spending Account): A health care FSA permits you to set aside pre-tax dollars to pay for health care expenses that are not covered by your insurance plan. When you sign up for an FSA you determine an amount that gets deducted out of your paycheck before taxes are taken out. This money then goes into a separate account. Once you incur expenses for health care (e.g., co-payments, acupuncture, contact lenses, or psychotherapy), you submit a claim to get reimbursed from that account. For example, let’s say you have to pay out of pocket $100 per psychotherapy session and you’re in a 25% tax bracket. Without the FSA you pay $100. If you use the money saved in your FSA you are in effect only paying $75 because you’re using money that has not been taxed. If you decide to see a therapist on an ongoing basis, this is a great way to save for your mental health care expenses. 

Fees

Fees are determined by your insurance plan and whether you choose to use it. Sessions are 50 minutes in length. Fees are due at the beginning of session. I accept cash and checks but do not accept credit cards.

I am currently on Blue Shield's panel of providers. If you have Blue Shield mental health coverage and wish to see me, please contact them using their customer service number on the back of your insurance card. Have them verify benefits and email or fax you the details of your coverage including copay and number of covered sessions. Bring this and your insurance card to the first session. This will help avoid any confusion about coverage. You will be responsible for your copay at the time of session.

If you are not a Blue Sheild patient, you must pay for the session in full at the time of service. I will provide you with a monthly statement that you can submit to your insurance company if you have out-of-network coverage. You may also submit the statement for reimbursement from your FSA as well. 

Please call my office for current fees and availability. 818-640-8356

 

Confidentiality

As your therapist I am legally bound to maintain confidentiality for you (subject to state laws). However, if you use insurance to pay for services, I am often required to disclose at a minimum your diagnosis and sometimes the details of treatment. Once this information leaves my office, neither you nor I have control over where this information goes, who sees it or what is done with it.

Basically, the trade-off is when you seek treatment through your insurance, you pay lower rates but have limitations regarding confidentiality, duration of therapy and choice of provider. Obtaining treatment outside of insurance coverage essentially ensures confidentiality and preserves your choice of provider and duration of treatment.