FAQs

About Us

SelfWorks Group: Therapy Professionals is a registered professional service corporation (PC) in New York.

 
Locations

1140 Broadway, Suite 204, New York, NY 10001

150 East 58th Street, 21st Floor, New York, NY 10155

 
Availability

Our licensed therapists have office hours Monday through Friday. Early mornings and evenings are available, upon request, to accommodate working schedules.

 
Cancellation Policy

Once you find a mutually agreed upon appointment time(s), it is expected that you will be present for your appointments. All cancellations under 48 hours notice will be charged $100. At SelfWorks, therapists hold a weekly scheduled appointment time specifically for you. This provides consistency and dedicated attention. Therefore it is difficult for therapists to fill a session with short notice. With advanced notice, therapists will try to find another time to reschedule sessions.

Missed or cancelled sessions are often inevitable. Life can get in the way of our best intentions. Yet, cancellations can also point to important work being uncovered in the treatment. Sometimes when therapy becomes challenging or hits upon an important topic, it can feel easier to skip a week or put off a session. It is most helpful to your well-being to be reflective when that cancellation urge arises and bring this up with your therapist.

 
Insurance Coverage

Understanding your insurance benefits can be confusing and difficult. We want to help bring clarity and ease to your benefits.

Our dedicated billing team has over 25 years’ experience working with insurance companies. Below we explain some common insurance terms, and how they may impact your services at SelfWorks.

 
In-Network

In-network means that we are part of an insurance company’s network of providers. As part of our contract with the insurer, we have a set agreement and standard set of rates for therapeutic services. Presently, we have agreements with Aetna commercial plans (not EAP or Medicaid); Lyra; and Northwell Direct.

 
Not all SelfWorks’ therapists are contracted with these insurance companies. Please check with us that your desired provider accepts your insurance plan.

 
With in-network plans, we can quickly verify your benefits and give you detailed information on what you can expect to pay based on your unique plan.

 
Deductible

Your specific insurance plans may have a deductible – a set amount of money you are expected to pay before your insurer will start chipping in for your healthcare. Your deductible accumulates throughout the year across the various healthcare services you receive, e.g., your primary care, specialty care, etc. Once you’ve reached this pre-set amount, your copay or co-insurance becomes your responsibility. Deductibles reset each year, either at the start of the calendar year or the insurance plan year (e.g., Nov-Nov). It is helpful to know when your deductible restarts so you can plan accordingly.

 
Co-Insurance and Co-pay

Once your deductible has been met, a co-insurance amount or co-pay amount will be assigned to each service. For co-insurance, this is the percentage of the bill that you are financially responsible for.  For example, if you have a 20% co-insurance, you will pay 20% of each session bill and your insurance company will cover the other 80%. Co-pays are a pre-set amount for office visits that are not percentage based. Co-pays are generally between $20-$50 per session.

 
Out-of-Network

Out-of-network means that we do not have a contract with your insurance company. For these plans, you are responsible to pay the full cost of your session on the day of service. Generally insurance plans with out-of-network benefits reimburse somewhere between 60-80% of what’s called the usual and customary rate (UCR). The UCR may be similar or different to our fees, so we recommend that you confirm the reasonable rate your specific plan uses.

Since we are not contracted with these plans, unfortunately, the healthcare system does not allow us to verify your benefits on your behalf. On your membership card, you have a members services number which gives you detailed answers about your mental healthcare benefits. Here are some helpful questions to ask:

  • What are my out-of-network mental health benefits for an office visit?
  • Does that differ if it is in-person or telehealth?
  • What is my out-of-network deductible, and has it been met? When does it restart?
  • What is a reasonable rate for billing code 90791 (the initial consult)?
  • What is a reasonable rate for billing code 90834 (a 45-minutes session)?
  • What is a reasonable rate for billing code 90837 (a 55-60 minute session)?
  • What is a reasonable rate for billing code 90847 (a couples or family session)?

They will tell you the percentage of the reasonable rate they reimburse.

 
Superbill

We can help you through the process by providing monthly superbills which can be submitted to insurance for reimbursement. A superbill has the required information your insurance provider needs when you submit a claim for reimbursement. The superbill will include your name, your provider’s name, your provider’s employment identification number, your provider’s National Provider Identifier number, the code(s) for your diagnosis, the code(s) for any services, the date of your appointment (date of service), and the total amount of the bill.

 
Out-of-Pocket Limit

An out-of-pocket limit is the maximum amount of your own money you will have to pay for care during the year. Think of the out-of-pocket limit as your deductible + coinsurance + copayments (if your plan has them) up to a total dollar amount. After you spend the out-of-pocket limit, your insurance company pays 100% of the cost.

Connect:

       

Locations:

1140 Broadway, Suite 204
New York, NY 10001
150 East 58th St, 21st Floor
New York, NY 10155

Fax:

(212) 213-4238