Offering telehealth services across the United States and in-person services in multiple NY, NJ & PA locations.
As a courtesy, we file insurance claims for our in-network plans. Once your insurance has processed a claim, any remaining balance is the patient’s responsibility, including charges from denied claims, services not covered by your plan, and fees for appointments missed or cancelled with less than 24 hours’ notice. To cover these balances, we ask that you keep a credit card on file in our secure system.
Please contact our office regarding our current private pay fee schedule. Our fee schedule includes our licensed doctoral level clinicians, our postdoctoral fellows, and our master’s level clinicians. All of our clinicians, regardless of credentials, have advanced training in our areas of practice specialization. We ensure that you will receive competent, well-trained, and compassionate care with any of our professionals.
Clients not utilizing in-network insurance are entitled to receive a “Good Faith Estimate” (GFE) detailing the expected costs of services. Clients will receive a GFE on an annual basis and upon initiating services at CEH.
For clients with insurance plans with which we are out-of-network, excluding Medicare or Medicaid, we encourage you to check your insurance benefits and consider filing out-of-network claims for reimbursement using any out-of-network benefits to minimize your cost.
We have partnered with Mentaya to help clients use their out-of-network benefits to save money on therapy. Use this tool below to see if you qualify for reimbursement for our services:
Use this estimator only if your services will be out-of-network.
This includes:
*This tool is for checking out network benefits only. If you have Aetna insurance for services provided in New Jersey, this tool will not reflect in-network benefits.
The Center for Emotional Health (CEH) is an in-network provider with most Aetna and Quest insurance plans. If your mental health benefits are provided by Aetna or Quest, we will check your benefits as a courtesy prior to your initial appointment. We also recommend that you check your eligibility and benefits. For other private insurance companies, we are considered out-of-network. You may, however, choose to utilize any out-of-network benefits you have by submitting claims for reimbursement following your visits.
For clients with insurance plans with which we are out-of-network, excluding Medicare or Medicaid, we encourage you to check your insurance benefits and consider filing out-of-network claims for reimbursement using any out-of-network benefits. We have partnered with Mentaya to help clients use their out-of-network benefits and encourage you to use the benefit checker above on this page or contact the phone number on the back of your insurance card to inquire about your out-of-network benefits.
No, CEH does not participate with Medicare or Medicaid. Please note that as opted-out providers with Medicare and Medicaid, neither we, nor clients may submit out-of-network claims for payment.
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.
You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 1-800-985-3059.
Payment for services received is expected the day that service is rendered.
CEH typically charges the amount of coinsurances and deductibles after claims have been processed and received from your insurance company. This ensures you are paying only what is owed. Insurance processing can take up to several weeks, so charges may be delayed from when the appointment occurred.
Please note that you will be charged the full session fee for any session missed without a minimum of 24 hours notice. Cancellation fees are not covered by insurance and are your responsibility. If you are ill, please consider the use of telehealth to keep your appointment. Emergencies or special circumstances where notice is unable to be provided are considered on a case-by-case basis and at the discretion of CEH. Please note that you will also be required to place a credit card on file to be used to charge any outstanding fees for which you are responsible.
Your insurance company may ask for CEH’s National Provider Identification number (NPI). CEH’s institutional NPI number is: 1679807531
Most commonly used therapy (CPT) codes:
Insurance companies may also ask for the diagnosis code associated with treatment. Diagnosis codes vary. Some, but not all, of the most common diagnoses we treat, include:
Where do I obtain information about my health plan?
Each subscriber in a health plan receives a policy handbook upon signing up for his or her insurance. If you receive health care benefits through your employer, they can provide you with a copy. Covered benefits vary from policy to policy and from insurance carrier to insurance carrier. It’s important that you read through your most recent handbook and know your policy, making notes of any questions you have.
If I have questions about my policy, where can I get them answered?
If your insurance is provided through your employer the human resources’ staff can assist you. If you purchased your insurance, the agent who sold you your policy should be able to answer your questions. Or you may contact your insurance carrier directly at any time. Typically their contact information is listed on the reverse side of your insurance card.
How will I know if my policy changed?
Your insurance carrier must notify you in advance of any changes in your policy. It is your responsibility to keep current of those changes. Isn’t my doctor’s office responsible for knowing my benefits? No. Healthcare providers are not responsible for knowing your policy and what is covered or not covered. Patient benefits vary widely with hundreds of different plans available in today’s market. Healthcare offices bill your insurance as both a courtesy and convenience to you as a patient. However, your benefits are your responsibility to know and understand.
Why does my doctor’s staff need to know my social security number?
Your doctor can legally request your social security number, and requires it to administer aspects of your health plan, such as obtaining prior authorizations for healthcare services. Every doctor’s office is required by law to maintain a high level of security over patients’ personal information. This information is never sold or provided to unauthorized individuals.
What are Prior Authorizations?
Many health plans require permission in advance of a patient receiving particular healthcare services in order for the service to be paid. Your healthcare provider usually will call to obtain authorization for a service, but it is your responsibility to know if your insurance requires prior authorizations.
What does participating provider or preferred provider mean?
This means that your healthcare provider has a contract in place with your insurance carrier to provide healthcare services to you for a predetermined fee schedule. Deductibles and copayments still apply.
What are Deductibles, copayments and coinsurance, and deductibles?
This is a set dollar amount that is required annually to be paid by the insured. The insurance will not pay any of your claims until this amount is paid by the patient. The healthcare provider must collect in full and is not allowed to adjust off any portion of this payment. Copayments: A set dollar amount that you are required to pay according to your insurance policy at each office visit. Co-insurance: The portion of healthcare expenses that you are responsible for after the deductible is met and the insurance has paid its portion. For example, your policy may read 80/20, meaning that your insurance will pay 80% of the claim and you will be responsible for the remaining 20%. Your policy manual can provide you with this information. Your insurance company determines the amount you pay. Again, medical providers are not allowed to adjust off your copayments or deductibles. It is your obligation to pay these amounts.
How can I find out if something is a covered service?
You can review covered benefits in your policy handbook or contact your customer service representative. They are responsible for helping you understand your policy. Additionally, review the explanation of benefits that your insurance carrier sends you after you have received healthcare services. This will explain your charges and how it was reviewed and paid according to your policy by the insurance carrier. Any dollar amounts you owe will match the statement you receive from the healthcare provider, as the healthcare provider obtains their information from the insurance carrier.
Detailed information and consent forms about our policies and procedures will be provided to you at the outset of services. Please feel free to reach out to us with any questions at mail@thecenterforemotionalhealth.com or (856) 220-9672. Billing inquiries can be directed to burgos@thecenterforemotionalhealth.com.