Insurance & Billing
Services may be covered in full or in part by your health insurance. If not covered in full, you will have an out-of-pocket cost per session for a co-pay/coinsurance or toward your insurance deductible. We do not determine insurance benefits, so you will need to contact your insurance provider to understand your specific plan’s benefits and costs. Each plan varies greatly, and it is your responsibility to understand what your plan offers for coverage.
Golden Vibes is in-network with most major insurance plans, and we’re glad to work with clients using out-of-network benefits. Quartz, Group Health Cooperative of South Central Wisconsin, Aetna, Cigna Healthcare, Florida Blue, Anthem, Dean Health Plan.
Aetna and Cigna are only accepted at our Florida location.
Dean, Quartz, and GHC are only accepted at our Wisconsin location.
Insurance Claims Details
In case of insurance claim denials, the client is held responsible for paying for the cost of the appointment out-of-pocket. Prior to your first appointment, you will need to contact your insurance provider’s member services to confirm your mental health services coverage. The member services phone number can typically be found on the front or back of your insurance card. You will want to ask things like:
- Do I have mental health benefits?
- What is my deductible, and has it been met?
- How many sessions per year are covered?
- What is my out-of-pocket cost per session?
- Does my plan have telehealth coverage?
Your insurance provider may ask what CPT codes will be used. We bill the first appointment to insurance using CPT code 90791, and follow-up appointments are billed using CPT code 90837 for a 53-60 minute session. If your insurance is out-of-network, appointments must be paid out of pocket. You may contact your insurance provider to see if your plan includes out-of-network benefits. If so, we can provide a superbill (an itemized receipt you can submit to your insurance provider for potential reimbursement after paying for services out of pocket). Please note that we do not submit out-of-network claims or communicate with your insurance provider. It is your responsibility to verify your plan’s reimbursement policies and procedures.
Self-Pay Details
We offer the option of self-pay for uninsured or out-of-network clients, or for clients who do not wish to use their insurance. Using insurance requires that a diagnosis be submitted, as treatment must be deemed “medically necessary.” If you are concerned about a diagnosis remaining on your permanent medical record or prefer not to frame your concerns in a medical model, you may choose to self-pay rather than billing through insurance.
Payment Details
As a courtesy, our billing team submits in-network claims to insurance companies on your behalf. Clients are responsible for confirming their insurance benefits prior to the first appointment. We do not submit out-of-network insurance claims on behalf of clients.
We require enrollment in AutoPay. A valid credit card, debit card, HSA, or FSA card must be kept on file and will be charged automatically for services rendered, including any client responsibility determined after insurance processing has been completed, as well as no-show or late cancellation fees.
We do not accept cash, checks, or third-party payments.
Declined or failed payments may result in a temporary hold on scheduling until the balance is resolved.
Reduced Fee
Reduced fee services are available on a limited basis. Please email us for more information.
Terms &Details
All clients are required to maintain a valid credit card, debit card, HSA, or FSA card on file and to sign a consent for automatic billing (AutoPay).
Payment information is stored securely within our Electronic Health Record system. The card on file will be charged automatically for applicable fees, including self-pay session fees, any client responsibility determined by insurance (such as copays, coinsurance, or deductible amounts) after insurance processing, and any late cancellation or no-show fees.
Cancellation Policy
If you do not attend a scheduled session or fail to provide at least 24 hours’ notice to cancel or reschedule, a late cancellation or no-show fee, you will be responsible for the full session fee. Insurance cannot be billed for missed appointments, and this fee is the client’s responsibility.