Office Policies, Fees & Insurance

Insurance

We are considered “Out-of-Network” providers by insurance companies.

  • If you are unfamiliar with your plan’s benefits, prior to arranging an appointment, call the customer service department of your insurance company and determine if your plan reimburses for “Out-of-Network (OON) providers.” Generally, most Preferred Provider (PPO) and Point of Service (POS) plans have an Out-of-Network benefit. (Many of my patients have Blue Cross Horizon benefit plans.)

If you have “Out-of-Network (OON)” benefits, your insurance reimbursement will be based on your company’s “Out-of-Network” benefit rate or the non-contracted provider rate. Usually this means that after your “Out-of-Network” deductible is met, your insurance will cover some portion of the fee.

  • You can learn your insurer’s “allowable rate” in your zip code area by asking the insurer’s customer service representative.
  • You should ask your insurer what percentage of the allowable rate your policy covers and if they limit the number of sessions permitted in a given year.

The procedure code (CPT) used for the initial Psychology Evaluation is 90791 and the code for individual therapy for 45-50 minute sessions is 90834.

  • Before you begin treatment you should also know if there are any pre-approvals or authorizations required by your insurance for Exposure Sessions (ERP) of extended duration (code 90837), sometimes applicable to the treatment of OCD.

If you are in a Health Maintenance Organization (HMO), have Medicare or Medicaid, your insurance will likely not reimburse you for Out-of-Network care.

 


 

Specialists and Single Case Agreement

Because some NJ networks do not have specialists trained in Exposure and Response Prevention (ERP) or Cognitive Behavioral Therapy, some insurance companies will enter into arrangements on a case-by-case basis to reimburse our patients at the “In-network rate,” often called a “single case agreement.”

The procedure for using this exception should be available from your carrier. Generally it requires you to determine that a fully trained CBT or ERP specialist is unavailable in your area. Please note that many therapists who claim to do cognitive work employ a mix of techniques including some CBT work, but lack formal CBT training or ERP training and expertise. Most insurers do not verify credentials or specialties other than state licensing.

Dr. Schonberg is Board Certified in Cognitive and Behavioral Psychology (ABPP) by the American Board of Professional Psychology and as a Diplomate and Certified Trainer/Consultant by the Academy of Cognitive Therapy (ACT).

 


 

Fee Structure

How much does a session cost?

Please call for our current fees. Be assured that our fees are comparable to those of other well trained and qualified psychologists in our area.*

  • Our fee for the initial evaluation is based on a 51-60 minute session, CPT Code 90791.
  • Following the initial evaluation, the fee for each subsequent session is based on a 45-50 minute session (CPT Code 90834). Our sessions are normally 50 minutes.
  • Sessions longer than 50 minutes are prorated in 10 minute increments.
  • Telephone consultation time greater than 10 minutes, report writing or other requested professional work is also billed at the hourly rate in 10 minute segments.

 

*Note: You can determine the average fees for psychotherapy services in Union, Essex, Morris or Somerset counties by visiting the website of “Fair Health’s” consumer cost look-up page.

 


 

Office Policies

What type of payment do you accept?

Currently we accept cash and checks.

Payment with a check or in cash is required at the time of each visit. I provide a receipt which you can submit to your insurance company for your direct reimbursement.

To cover any additional bookkeeping fees we incur, we reserve the right to charge late payment fees for those whose account is not kept current.

 


 

Cancellation

For cancellation of a scheduled appointment without charge, we request 24 hour advance telephone notification. Appointments cancelled with less than 24 hours notice will be billed for the missed appointment. Insurance reimbursement is usually not available for missed sessions.

 

The Statement of Understanding Form contains the details of our other office policies and can be downloaded from the “Forms Page

 


 

New Patient Forms

 

* Please note that the forms may appear in the “Download” section of your browser if your browser does not have a PDF reader enabled.

 

  1. New Patient Agreement and Information. The form requests demographic data, contact information, and summarizes the payment policy. Please complete and sign for your first visit.
  2. Our client evaluation questionnaires are available on this website. We request that you print and complete either the Adult or Child form prior to your visit. This process will save you time during your initial evaluation and will help us to devote session time to your most immediate concerns.
  3. The Permission to Treat a Child Form should be signed by the parents or guardian of client’s who are under 18 years of age.
  4. Our Office Polices are explained in greater detail in the Statement of Understanding/Contract Form also found on the Forms Section. Please review this form and be sure to ask any questions you may have about its contents at our first appointment.
  5. The HIPPA form reviews your health privacy information specific to the field of behavioral health. Please print and sign the last page and bring to your first visit.
  6. Release Form gives CTC, LLC permission to discuss selected aspects about your care with the person/s that you designate.

 

 

Disclaimer

 

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