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Cuotas por servicios profesionales
Terapia individual
$200 por 50-minutos de sesión de terapia individual
$225 por 50-minutos de sesión evaluación inicial de terapia individual
Consultas
Estoy disponible para proveer servicios de consulta a individuos o organizaciones en cualquier parte de Estados Unidos, y otros paises. Si esta interesad@, me puede contactar para recibir más información sobre mis servicios.
Service Fee Agreement: When we agree on a service fee for self-pay services, I will provide you with a separate form titled “Service Fee Agreement” that you can complete and sign via the Electronic Health Record (EHR) system. The Service Fee Agreement will establish an agreement between us for professional services, service fees, and the duration of these service fees. We will establish a new Service Fee Agreement anytime there is a change in the services received and / or service fee amounts.
Reduced Fess for Self-Pay Therapy (Individual & Family) Services
I provide clients who self-pay for therapy services the option of a reduced fee. A reduced service fee is based on trust, since I do not ask for any documentation or verification of income/ expenses.
Reduced Service Fees:
I. “Green Bottle Method” Service Fees
I provide all clients who self-pay for therapy services the option for “Green Bottle Method” Service Fees. To choose a service fee that works for you, you will need to take an honest inventory of your financial situation, and to reflect on which of the bottles most accurately reflects your current financial situation and life experience. We can agree on a service fee and establish a Service Fee Agreement.
Left Bottle: $200
Middle Bottle: $170
Right Bottle: $140
“Please be mindful that if you [choose] […] at the lowest end of the scale when you can truthfully afford the higher [service fee] […], you are limiting access to those who truly need the gift of financial flexibility.”
“[Consider] the idea of sacrifice versus hardship when examining access. If paying for a […] service would be difficult, but not detrimental, it qualifies as a sacrifice. You might have to cut back on other spending in your life (such as going out to dinner, buying coffee, or a new outfit), but this will not have a long term harmful impact on your life. It is a sacred sacrifice in order to pursue something you are called to do. If, however, paying for a […] service would lead to a harmful impact on your life, such as not being able to put food on the table, pay rent, or pay for your transportation to get to work, then you are dealing with hardship. Folks coming from a space of hardship typically qualify for the lower end of the sliding scale.”
Statements written on the “Green Bottles” that describe a person’s possible economic situation (click on arrows):
Top of the Scale (or the left bottle):
I am comfortably able to meet all of my basic* needs
I may have some debt but it does not prohibit attainment of basic needs
I own my home or property OR I rent a higher-end property
I own or lease a car
I am employed or do not need to work to meet my needs
I have regular access to health care
I have access to financial savings
I have an expendable** income
I can always buy new items
I can afford an annual vacation or take time off
Middle of the Scale (or the middle bottle):
I may stress about meeting my basic needs but still regularly achieve them
I may have some debt but it does not prohibit attainment of basic needs
I own or lease a car
I am employed
I have access to health care
I might have access to financial savings
I have some expendable income
I am able to buy some new items & I thrift others
I can take a vacation annually or every few years without financial burden
Bottom of the Scale (or the right bottle):
I frequently stress about meeting basic needs & don’t always achieve them
I have debt and it sometimes prohibits me from meeting my basic needs
I rent lower-end properties or have unstable housing
I do not have a car and/or have limited access to a car but I am not always able to afford gas
I am unemployed or underemployed
I qualify for government assistance including food stamps & health care
I have no access to savings
I have no or very limited expendable income
I rarely buy new items because I am unable to afford them
I cannot afford a vacation or have the ability to take time off without financial burden
* Basic Needs include food, housing, health care, and transportation.
** Expendable Income might mean you are able to buy coffee or tea at a shop, go to the movies or a concert, buy new clothes, books, and similar items each month, etc.”
- Excerpts from the article “The Sliding Scale: A Tool of Economic Justice (aka The Green Bottle Method),” written by Alexis J. Cunningfolk. To learn more, please visit: http://www.wortsandcunning.com/blog/sliding-scale.
II. Student Service Fee
I reserve a limited amount of slots on my caseload to provide a Student Service Fee to students who self-pay for therapy services. The Student Service Fee of $110 is based on financial need. I ask students to first consider the “Green Bottle” Method service fees, and their life and financial circumstances. If you feel you have the financial need for a Student Service Fee, please let me know and we can have a discussion, and if appropriate, we can establish a Service Fee Agreement with this fee.
III. Lower Reduced Service Fee
I reserve a limited amount of slots on my caseload to provide a Lower Reduced Service Fee to clients who self-pay for therapy services. This Lower Reduced Fee is based on financial need, and it is approved on a case by case and short term basis. I ask clients to first consider the “Green Bottle” Method service fees, and their life and financial circumstances. If you feel you have the financial need for a Lower Reduced Service Fee, please let me know and we can have a discussion, and if appropriate, we can establish a Service Fee Agreement for a Lower Reduced Fee.
Professional Fee Raises
Las cuotas profesionales de mi practice subirán por $10 anualmente el primero de Enero de cada año.
For current self-pay clients, the Service Fee Agreement is valid for the services, service fee amount, and duration established, unless we establish a new Service Fee Agreement.
Cancelaciones y citas de terapia donde no se presente
Tengo pólizas estrictas sobre cancelaciones y citas de terapia donde no se presente. Por favor asegúrese de re agendar o cancelar la citas por los menos con aviso previo de 48 horas.
If a client cancels their session less than 48 hours in advance, or they miss they scheduled session, you will be charged a $125 fee. When a client schedules an appointment, I reserve that spot and time exclusively for them.
Billing and Payments
You can learn more about all the treatment payment methods available by reading below (click on the arrows):
Self-Pay Clients
Acceptable payment methods include: checks, and all major credit, debit, FSA, and HSA cards. Please make all checks payable to: Melissa Pérez. A $10.00 service charge will be charged for any checks returned for any reason for special handling.
Payments for Telehealth sessions are processed through the Electronic Health Record (EHR) system, a secure and HIPAA-compliant platform. Payment for a Telehealth session is expected at the time services are rendered. Payment schedules for other professional services will be agreed upon as they are requested. Please ask me if you wish to discuss a written agreement that specifies an alternative payment procedure.
Good Faith Estimate and the “No Surprises” Notice: Self-pay clients will be provided with a Good Faith Estimate and a “No Suprises” notice. The Good Faith Estimate explains how much your care will cost. Under the law, health care providers need to give clients who don’t have insurance or are not using insurance (including clients who pay out-of pocket and request insurance reimbursement) an estimate of the bill for medical items and services (including psychotherapy). You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services, including psychotherapy services. The “No Surprises” notice reviews these client rights.
Aseguranza - In Network Provider
I currently only accept the Lyra Health insurance plan in my private practice for individual therapy.
Please note that you are responsible for payment of your therapy service fees, regardless of whether or not they are covered by your insurance. If you are using your insurance benefits, please note that certain professional services outside of your presenting problems, such as medical record preparation requests, and participation in legal proceedings, may be outside the services paid for by your insurance or sponsoring employer and may incur you additional service fees. Any additional service fees will be discussed and agreed upon when they are requested.
If you are using the Lyra Health insurance plan, please note that the fees for your sessions will be paid for by your sponsoring employer as long as you are eligible, subject to any limits under your benefit plan, and as long as sessions are considered clinically appropriate.
Insurance - Out-of-Network Provider
If you have an insurance plan not listed above, there is a possibility that I may be considered an out-of-network provider. This is primarily for individuals with Preferred Provider Organization Plan (PPO) insurance.
A client would pay the full fee of $200 per 50 minute session at the time of service. I would provide them with a monthly superbill, and then they would be responsible for processing their claim for direct reimbursement with their insurance company. The rate for reimbursement would depend on your insurance plan and out-of-network benefits, and would most likely be a partial reimbursement.
Please note that some insurance policies have a deductible that clients must meet before being eligible for reimbursement. I recommend you speak with your insurance and ask clarifying questions about your insurance plan, and the reimbursement rate and deductible for mental health care for out-of-network providers.
Some helpful questions to ask your insurance provider before our first appointment:
Do I have out-of-network mental/behavioral health benefits?
Do I have an out-of-network deductible that has to be met first before I get reimbursed? Has any amount of my deductible been covered this year?
How much would I get reimbursed?
What is the usual and customary rate covered by my insurance for outpatient psychotherapy (CPT code 90834) (This is a specific code insurances use for billing)?
Is approval or pre-authorization required?
Is there a limit to the amount of sessions I can have in a year?
How do I submit claim forms for reimbursement?
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