We Accept Insurance!

Removing barriers to accessing quality mental health therapy is important to us. That’s why we have chosen to partner with a variety of widely used insurance agencies. We currently accept the following, insurances:

• Anthem Blue Cross and Blue Shield New York (formerly empire)

• Aetna

• Cigna

• Carelon Behavioral Health

• Quest Behavioral Health

Please Note:

• Insurance benefits vary by plan, and coverage is determined by each individual insurance provider.

• While insurance may cover a portion of therapy services, clients are responsible for understanding their specific benefits, including copayments, coinsurance, deductibles, and session limits.

• Insurance companies make the final determination regarding coverage and reimbursement.

• Clients are financially responsible for any portion of fees not covered by insurance. Clients are responsible for notifying the practice of any changes to insurance coverage, including plan changes, termination of benefits, or changes in subscriber information. Failure to update insurance information may result in delayed claims or client responsibility for outstanding balances.

Self-Pay Option

Clients may choose to pay privately for services rather than using insurance. Self-pay clients may choose whether or not to receive a superbill for potential out-of-network reimbursement.

What’s is a Superbill?

A superbill is a detailed receipt that clients who pay privately for therapy services may use to seek possible reimbursement from their insurance company as an out-of-network benefit. A superbill typically includes required information such as the provider’s credentials, license information, dates of service, service codes, and a mental health diagnosis. Submission of a superbill does not guarantee reimbursement, as all reimbursement decisions are determined by the insurance provider.

Clients are responsible for contacting their insurance company to confirm out-of-network benefits and for submitting the superbill directly to their insurer. Calming Corner does not communicate with insurance companies on behalf of self-pay clients.

Benefits of Superbills:

1. Transparency - It provides a clear breakdown of services, costs, diagnosis codes (ICD), and procedure codes (CPT), helping patients understand what they are paying for.

2. Potentially More Affordable - In some cases the reimbursement received, lowers your out of pocket costs. Here’s an example:

   • Your insurance company requires you to pay a $25 copay for therapy sessions. Your session fee is $100. Instead you decide to pay for the session upfront and submit a superbill to your insurance company. Your insurance company reimburses you $85. Making your total out of pocket cost $15, which is lower than the $25 copay.

3. Enables Use of HSA/FSA Funds:
   A superbill can be used as documentation to reimburse healthcare spending accounts (HSAs or FSAs).

4. Tax Deductions - Can serve as proof of medical expenses when filing for deductions during tax season.

Helpful Questions to ask your insurance company:

1. What is my out-of-network coverage for outpatient mental health services?

2. Do I have a deductible? How much of it has been met this year?

3. Is there a session limit per year?

4. What is the "allowed amount" that will be reimbursed per session?

5. Do I need pre-authorization or a referral to work with an out-of-network provider?

6. How do I submit claims for reimbursement?

7. Are tele-therapy (virtual sessions) covered?

8. Are there any other limitations or requirements I should know about?

Self pay session fees:

• Individual Therapy - 60 minutes | $90 per session

• Individual Therapy - 45 minutes | $65 per session

ESA Services

ESA-related services are considered administrative and evaluative services and are not reimbursable by insurance. Superbills are not available for ESA evaluations or documentation. Payment is due prior to the completion of any ESA-related documentation.

ESA Services Fees:

• An evaluation and letter need to be provided in conjunction. The total cost of this service is $250. $150 is due at start of service and $100 is due prior to receiving your ESA letter.

• If you need a renewal and received your initial evaluation and letter from Calming Corner, the renewal fee is $150. This includes an updated evaluation and letter.

• If you need a renewal and did not receive your initial evaluation and letter from Calming Corner, but have a prior letter that needs renewal, the renewal fee is $200. This includes an updated evaluation and letter.

Clinical Supervision

Clinical supervision is offered to social workers seeking professional growth, support, and guidance toward licensure or ongoing development.

Clinical Supervision fee:

• Individual supervision - 60 minutes | $75 per session