Insurance and Fees
Therapists at Capstone offer sliding scale pricing. We have fully licensed counselors and therapists with years of experience, as well as master level clinicians under supervision, and graduate interns who are completing their graduate program requirements. Rates range from $150 to $350 per session. Lower rates are available with our interns and pre-licensed clinicians. Got questions? Call us at 770 744-5055 or email us at info@capstoneatlanta.com.
Did you know you can offset the cost of therapy with superbills?
Yes, in the United States, hundreds of millions of superbills are generated each year. Utilizing superbills is an effective way to offset your cost of therapy sessions.
What is a Superbill?
A superbill is a detailed document used in healthcare settings that outlines the services a provider has delivered to a patient. It includes information necessary for insurance reimbursement and patient billing, particularly for out-of-network providers or when a patient is seeking reimbursement directly from their insurance.
Superbills are primarily used by healthcare providers to submit claims to insurance companies or provide a document for patients to submit claims for reimbursement. It helps ensure that both parties (patients and insurance companies) have a record of the healthcare services provided and the associated costs. A superbill includes:
Patient and provider details: The patient's name, contact information, and insurance details, as well as the healthcare provider’s name, credentials, and contact information.
Diagnosis codes (ICD-10 codes): These codes describe the patient's medical condition or the reason for the visit.
Procedure codes (CPT or HCPCS codes): These codes describe the services or treatments provided to the patient.
Date of service: The date when the healthcare service was provided.
Charges for services: The costs associated with each service rendered, often itemized.
Provider’s NPI (National Provider Identifier): A unique identifier for healthcare providers.
To learn if you can submit superbills to offset your cost for therapy, we've detailed the questions to ask when you call your health insurance provider:
Questions To Ask Your Health Insurance Provider
1
"Does my plan cover reimbursement for psychotherapy with an out-of-network provider?"
If yes, ask these questions next...
2
"According to the usual customary fee, what is the maximum reimbursement amount I can receive based on the internal fee schedule?"
The usual customary fee refers to the cost of one therapy session. This is also known as UCR which stands for "Usual, Customary and Reasonable". Your insurance provider should be able to quote over the phone the amount you will be reimbursed based on your insurance plan. You will need to provide the cost per session confirmed by your therapist.
3
"Are there any restrictions or limitations I should be aware of based on my individual insurance plan?"
For example, some health insurance providers offer reimbursement for a set number of sessions (i.e. 10 sessions within a calendar year). This is good information to know up front. You will want to share this information with your therapist to consider when writing your treatment plan.
4
"What is the process for submitting a superbill for reimbursement?"
Take notes so you have this information ready on hand when it's time for you to submit your superbill.
5
"What mental health benefits are covered with my current plan?"
Remember to ask if there are any restrictions and/or limitations for mental health services that are included in your current healthcare plan.
Once you have all of this information, you can evaluate and determine if working with an out-of-network provider is the best decision for you.
There is no health without mental health. Therapy is an important investment in your mental, emotional and physical well-being.
If you choose to proceed with submitting superbills to help cover your cost for therapy, remember to inform your therapist that you require a superbill for insurance reimbursement.
The superbill will be emailed to you the day after your therapy session. You can submit this to your insurance provider for reimbursement direct to you.
We hope this explanation of the process for submitting superbills was informative to help you maximize your health insurance benefits with out of network providers.
Thank you, Welcome and See you soon!