SelfWorks Group: Therapy Professionals is a registered professional service corporation (PC) in New York.
Our licensed therapists have office hours Monday through Friday. Early mornings and evenings are available, upon request, to accommodate working schedules.
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 $175. 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.
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 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.
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 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:
They will tell you the percentage of the reasonable rate they reimburse.
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.
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.
Good Faith Estimate
Good Faith Estimate for your care: Under the law (§ 2799B-6 of the Public Health Service Act) 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 a right to receive a Good Faith Estimate for the total expected cost of any non-emergency services. You can ask me for a Good Faith Estimate in writing before you schedule a service. Make sure to save a copy of your Good Faith Estimate. For more information visit www.cms.gov/nosurprises.