Insurance and Private Pay
Insurance
We are in-network with the following health insurance plans:
Horizon Blue Cross Blue Shield of NJ PPO (traditional plans only)
Blue Cross Blue Shield (BCBS) PPO
Aetna PPO
Aetna HMO (in New Jersey only)
Aetna EPO
Aetna Managed Choice
The name of your insurance may be different depending on your state (e.g., Horizon BCBS of New Jersey, CareFirst Blue Cross PPO in Maryland). Most people have a copayment of $10 to $30 per session and your insurance covers the rest of the cost. Some plans have a deductible. We would be happy to give you an estimate of your coverage by clicking below.
We are not in-network with the following plans (not exhaustive list):
Medicare
Medicaid
BCBS Managed Care plans, including:
BCBS HMO plans
BCBS EPO / OMNIA plans
BCBS NJ DIRECT
BCBS Direct Access
Private Pay / Self-Pay
If you do not have an in-network plan (i.e., Blue Cross Blue Shield PPO, Aetna PPO, Aetna HMO, Aetna EPO, Aetna Managed Choice) or prefer not to use your medical insurance for any reason, we would be able to offer you a private pay fee of $180 per ~50-minute therapy session ($230 for a 60-minute diagnostic intake). Self-pay would remove involvement with health insurance entirely, thus ensuring increased privacy. You have the right to receive a "Good Faith Estimate" of expected charges, which explains how much your medical care will cost. Learn more about Good Faith Estimate by clicking the corresponding button below.
Get an Estimate
We would be happy to give you an estimate of your health insurance coverage (e.g., copayment, coinsurance, deductible, and more) before booking an appointment.
We are only able to provide an estimate for Blue Cross Blue Shield and Aetna insurance plans.
Out-of-Network Reimbursement
If you have other insurance (not BCBS PPO, Aetna PPO, Aetna HMO, Aetna EPO, or Aetna Managed Choice) and plan to submit claims for out-of-network reimbursement, our out-of-pocket rate is $180 per 50-minute therapy session ($230 for a one-time 60-minute diagnostic intake). Please scroll down to the next section for more information. We will also send you a "Good Faith Estimate" of expected charges, which explains how much your medical care will cost. Learn more about Good Faith Estimate by clicking the button below.
Out-of-Network Reimbursement
New Brunswick Therapy is only in-network with the following plans: Blue Cross Blue Shield (BCBS) PPO, Aetna PPO, Aetna HMO, Aetna EPO, and Aetna Managed Choice. If you have other health insurance that is not BCBS PPO or Aetna and plan on submitting claims for out-of-network reimbursement, this is a brief explanation of what it is and how it works. This is an approximation and the steps may vary depending on your insurance provider.
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Out-of-network means that a healthcare provider does not have a contract with your health insurance plan provider. Most PPO and POS plans reimburse around 50-80% for out-of-network providers. Most HMO and EPO plans will not cover care from out-of-network providers at all, except sometimes in cases of an emergency.
For example, New Brunswick Therapy is not contracted with UnitedHealthcare or Cigna. We are also not contracted with Medicare or Medicaid, even if they are provided by BCBS or Aetna. That means we are an out-of-network provider for these insurance provider plans.
Out-of-network reimbursement means that you would be responsible for paying the full fee for services up front and your health insurer reimburses you a percentage of the total cost.
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An out-of-network deductible is the amount of money you are responsible for paying before you are eligible for reimbursement from your insurance.
Example: You have an out-of-network deductible of $1,000 and your insurance company pays for 80% of services after you have met that amount. That means you would have to pay $1,000 out-of-pocket, after which you will have “met your deductible,” then 20% of all sessions thereafter. In this scenario, if you have spent $1,500 on therapy services, you would have paid $1,100 out-of-pocket, and the remaining $400 would be reimbursed to you in the form of a check that is mailed to you from your insurance company after you submit your claim.
Deductibles reset every calendar year, and any health expenses you pay out-of-pocket contributes to meeting it.
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Coinsurance is the percentage of the service fee that you are responsible for paying.
Example: At New Brunswick Therapy, we charge a service fee of $180 for a therapy session. If your out-of-network insurance policy only covers $160 of $180 for a therapy session and your coinsurance is 30%, that means you would be responsible for paying $68 per therapy session (i.e., $160 x 30% + $20). Just remember that this comes in the form of a reimbursement, so you’ll need to pay the full amount of $180 up front, then your insurance will send you a check for $112 for therapy. You will likely receive the check by mail after the session, once you have met the deductible and submitted a claim.
Some insurance companies determine an “allowed amount,” which limits the session fee they will cover. If your insurance has determined $100 is their “allowed amount” per session, at a 30% coinsurance rate, your insurance company will still only reimburse you up to $70, no matter what our therapists’ session fees are. In other words, if your insurance has an allowed amount of $100 but your therapist’s session fees are $180 per therapy session, you won’t get reimbursed more; you’ll still be reimbursed $70, and you will be responsible for $110.
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Your out-of-network benefits are usually listed in the Summary of Benefits information on your insurance company’s website or by calling the Member Services number on the back of your health insurance card.
You are encouraged to contact your insurance company and ask them:
1. Is out-of-network reimbursement included in my plan?
2. Can I see an out-of-network provider for outpatient mental health?
3. What percentage of the fee will you cover for a 60-minute outpatient individual psychotherapy session? How much will I be reimbursed?
Your insurance company may request the following information about New Brunswick Therapy:
Practice Name: New Brunswick Therapy LLC
CPT Codes:
Intake online: 90791-95
Intake in-person: 90791
Individual therapy online: 90837-95
Individual therapy in-person: 90837
NPI Type 1: 126-508-0345NPI Type 2: 140-759-2496
Mental health provider, outpatient
Place of service: Telehealth or Office
Doctoral-level provider (clinical psychologist)
4. What is my out-of-network deductible? How much of my out-of-network deductible has been met this year?
5. What, if any, are the limitations on number of sessions and/or dollar amount per calendar year?
6. Do I need a referral from an in-network provider to see someone out-of-network?
7. How do I submit claim forms for out-of-network reimbursement?
8. How long will it take for me to receive out-of-network reimbursement?
The answers to these questions will explain what your out-of-pocket expenses will be.
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After you confirm your out-of-network benefits with your insurance provider, you would then pay New Brunswick Therapy LLC directly for services by card, and then you submit a detailed receipt that we provide you (referred to as a superbill) to your insurance. From there, your insurance should mail you back a check for a percentage of what you paid us.
Most PPO plans reimburse around 50-80% for out-of-network providers.
Example: Our billable out-of-pocket rate is $180 for therapy and some clients have 70% reimbursement after they have met their out-of-network deductible (if they have one). If your benefits are similar, you would hopefully only be paying around $52.50 per therapy session when the out-of-network reimbursement is accounted for. In principle, it is pretty simple, but it can be cumbersome to do depending on your insurance provider.For your convenience, we generate superbills for you on the first weekend of the month for all sessions that occurred during the month prior. We will upload your superbill to your TherapyPortal™ client portal, where you can download the document. From there, you may be able to upload the superbill to your insurance’s online portal (or whichever method they want you to submit claim forms) and then your insurance company would send you a check.
New Brunswick Therapy will also send you a "Good Faith Estimate" of expected charges, which explains how much your medical care will cost. Learn more about Good Faith Estimate by going to www.newbrunswicktherapy.com/goodfaith
Cancelling an appointment?
Late cancellations, no shows, and frequent cancellations may be subject to a charge of the full fee of your session (not just your copayment). Please review the cancellation and rescheduling policy by clicking the button below.
When are payments due?
When a client registers for services, they are prompted to create a TherapyPortal™ secure client portal account and put a card on file with our billing system. A client’s credit card, debit card, or FSA/HSA card will be charged using the TherapyPortal™ integrated Online Payments feature. Generally, clients will be billed the same day following their appointment. Clients using insurance will typically be charged their copayment and/or coinsurance on the same day following their appointment, while it may take several weeks for insurance claims to be completely processed. Clients paying privately or out-of-pocket with out-of-network benefits will be charged the full amount of the session on the same day after their appointment. If you need to make different arrangements, please let your therapist know so you can discuss if there are any mutually agreed upon options.
Court Action and Legal Fees
Clients are strongly discouraged from having their therapist subpoenaed or having them provide records for the purpose of litigation. Even though the client is responsible for the testimony fee and other court preparation fees, it does not mean that the therapist’s testimony will be solely in the client’s favor. Therapists can only testify to the facts of the case and, if qualified to do so by the court, in their professional opinion. Asking a therapist to provide confidential records or testify can damage the trust built in a counseling relationship with a client especially if the therapist is still seeing that client in therapy. If one of our therapists is subpoenaed to testify or provide records in a case where our client is a child, the therapeutic relationship is effectively ended, and it is very likely we will not continue to provide services to that child/family.
If a therapist with New Brunswick Therapy LLC is to receive a subpoena, then the attorney or office staff will need to call our office and set up a time for the subpoena to be served during office hours. The therapist will request a minimum of 72-business-hours notice of any court appearance so that schedule changes for their clients can be made within a reasonable time frame.
Fees for Court Preparation and Appearance
Please note that our therapists’ fee to appear in court is $1,500 (one thousand-five hundred dollars), minimum, per appearance. In the event that the therapist receives a subpoena to appear in court to testify on the behalf of a client, a client’s child, or any other family member, there will be a fee of $1,500. We do not voluntarily testify in court cases.
Other fees include:
$225 per hour to prepare records for submission to court (billable in 30-minute increments);
$225 per hour for phone contacts (billable in 30-minute increments);
$200 per hour for email or written letters (billable in 30-minute increments);
$250 per hour for depositions;
$250 per hour for time required in giving testimony;
$0.56 per mile for travel plus cost of airfare or transit if required;
$220 per hour for time away from office due to depositions or testimony;
$100 plus court fees for filing a document with the court; and
All attorney costs incurred by therapist as result of legal action.
A retainer of $1,500 is due in advance, at least 72-business-hours before the scheduled court appearance. The remainder of the costs will be billed after the court appearance and due upon receipt. If a subpoena or notice to meet attorney(s) is received without a minimum of 72-business-hour notice, there will be an additional $350 “express” charge. If the case is reset with notice of less than 72-business-hours, the client will be charged $500 (in addition to the retainer of $1,500). All fees are doubled if the therapist must postpone or interrupt prior plans to go out of town.
Note that this fee is payable seven (7) days prior to the client’s court date. Since the therapist will be required to clear their calendar of all appointments and prior engagements so that they may be available to appear in court, this fee is non-refundable. If the court date is postponed and the therapist must again clear their calendar to attend court, the client will again be charged the full fee. If the client’s court date is cancelled this fee is non-refundable.
No further appointments will be scheduled until this fee is paid in full. If this payment is not paid in full within one calendar month it will be brought to collections.
Divorce/Custody Cases
Please be advised that, if the therapist receives a subpoena to testify in a divorce/custody case, they will not make a custody recommendation, or a recommendation of where a child should live, nor will the therapist make a determination as to one’s fitness as a parent.
Confidentiality
Clients’ rights to privacy and confidentiality are important to us, and we work hard to protect them. There are also laws in place to protect the client. Please note there are situations during court and legal proceedings where they may be compromised. Examples of this include waiving confidentially by agreeing to disclosure of the client’s mental health records in a lawsuit for emotional distress; the client’s decision to pursue a lawsuit where the client’s mental or emotional condition is relevant or critical; if the client’s records are requested by a valid subpoena or court order. It is the client’s responsibility to learn how to confidentially and privacy may be compromised as a result of legal or court proceedings.
Non-Payment
If the client has not paid their court-related fees and does not respond to our attempts to contact the client and work out a payment plan, we have the option of using legal means to secure the payment. This involves hiring a collection agency or going through small claims court. In most collection situations, the only information we release regarding a client’s treatment is their name, the nature of the services provided, and the amount due. A late fee of 20% of the unpaid balance will be charged each month that a balance remains unpaid.
