Disclosures
Culturally competent, spiritually sensitive,
and trauma-informed.
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in- network facility but are unexpectedly treated by an out-of-network provider.
You are protected from balance billing for:
Emergency services
If you have an emergency medical condition and get emergency services from an out-of- network provider or facility, the most the provider or facility may bill you is your plan’s in- network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.
Certain services at an in-network hospital or ambulatory surgical center
When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.
You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.
When balance billing isn’t allowed, you also have the following protections:
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
Your health plan generally must:
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
Cover emergency services by out-of-network providers.
Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
If you believe you’ve been wrongly billed, you may contact The Ohio Department of Insurance (ODI).
Visit www.insurance.ohio.gov for more information about your rights under federal law.
Confidentiality is the expectation that the information you disclose to a Hope Behavioral Health Therapist will be kept private, including the fact that you are counseling with them at all. All records and session content remain confidential unless you sign a release of information.
There are important exceptions to confidentiality that are legally mandated. Exceptions include:
If your therapist believes you intend to harm yourself, or someone else
If your therapist suspects child abuse, elder abuse, or neglect
If subpoenaed and ordered to share confidential information
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that provides privacy protections and patient rights with regard to the use and disclosure of your Protected Health Information used for the purpose of treatment, payment, and health care operations. The law requires that we obtain your signature acknowledging we have provided you with this information; by signing our Releases and Consents you are certifying that you have been given a copy of the Notice. You may revoke this agreement in writing at any time. Please understand that all files are kept confidential. Your written consent is required for any release of information.
$175 - Initial diagnostic assessment (90 minute session)
$135 - Psychotherapy (60 minute counseling session)
$55 - Group psychotherapy (60 minute counseling session)
Don't forget that insurance can greatly reduce the cost of counseling sessions. In some cases insurance will cover 100% of the cost, but most people will have a co-pay or co-insurance.
Keep in mind that even though you have in-network insurance you will still have have to first meet your deductible before insurance benefits are covered. It is important to know what your health insurance benefits are and what is covered in accordance with your stated benefits in your insurance plan.
All co-pays and co-insurance fees are due at the time services is rendered. Even if you haven't meet your deductible you will receive a significant discount from our standard rate by only having to pay the approved in-network rate. In addition, any payment made is applied to your deductible.
If you have secondary insurance coverage, we must have that information related to your other insurance in order for your primary insurance to cover the cost of your care based on the insurances' coordination of benefits policy.
Fees are established within the median range of behavioral health service for diagnostic, psychotherapy and group psychotherapy services, and are considered reasonably priced within industry norms of the area.