Insurance & Fees
Insurance:
We provide counseling and psychotherapy as an out-of-network provider. It is the client’s responsibility to understand their insurance coverage and to verify their health insurance benefits for services provided by True Life Restorative before the initial intake.
Out-of-Network:
Billing out-of-network means patients pay a discounted private pay rate at the time of service. Upon request, a superbill will be provided for you to submit to your insurance carrier. Support and guidance are available to ensure this process is as simple as possible. Below are who we bill out-of-network with:
Pacific Source – Commercial
Pacific Source - Medicaid/OHP
Oregon Health Plan - Open Card
Blue Cross Blue Shield Network
Moda
Providence
United
EBH
AETNA
Cigna
Discounts:
We offer a 25% discount to all self-pay clients. We offer a superbill if needed. We can also accept payment from a Health Savings Account (HSA) or Flexible Spending Account (FSA).
Sliding Scale:
We have limited availability for sliding scale fees based on financial need. Please contact us to discuss this further.
“Self-care is never a selfish act - it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to our true self and give the care it requires, we do it not only for ourselves, but for the many others whose lives we touch.”
Parker J. Palmer
Let Your Life Speak
Benefits of Private Pay:
Many benefits come with paying for services without the complexity of insurance company involvement. The following is a list of benefits that you receive by utilizing private pay:
You receive increased confidentiality due to us not sharing your personal and protected information with your insurance company.
A mental health diagnosis is not mandatory and is not submitted to your private health records.
No insurance equals less documentation, which results in more quality time to focus on therapy.
No session limits
You are able to choose the focus, duration, and frequency of therapy.
You hold the ability to seek specific professionals that suit your needs rather than an insurance company telling you whom to see.
A 25% discount is offered to private pay clients, meaning that clients can actually pay less than those with insurance.
When your insurance changes, you will be able to stay with your therapist.
Research shows that clients who have to pay something for their treatment have more positive outcomes than those who receive treatment for free.
Payment / Card on File Policy:
True Life Restorative accepts all major credit cards, debit cards, Health Savings Account (HSA), and Flexible Spending Account (FSA) as forms of payment. Clients are required to keep a card on file with True Life Restorative for payment, missed appointment fees, and late cancellation fees. All cards will be charged automatically on the day of service or missed appointments.
Cancellation and Missed Appointment Policy:
True Life Restorative requires a 24-hour notice to cancel an appointment without a fee. Cancellations for Monday appointments should be made by the appointment start time of the preceding Friday to avoid the cancellation fee. A late cancellation fee of $75 applies to all appointments that are not attended or canceled with less than a 24-hour notice. True Life Restorative will keep your credit card on file, and you will automatically be charged if an appointment is not attended or canceled without a 24-hour notice.
YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS
(OMB Control Number: 0938-1401)
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 protection 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: cms.gov/nosurprises or call HHS at (800) 368-1019.
Visit:https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.