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Barbara E. Kaplan, MHDL

Counseling for Individuals, Couples, Partners, Marriages, Families

704-333-1510

Fees & Insurance

Fees

$123.00 or $136.00 for a 60-minute session based on the client's gross family income; and $93.00 or $103.00 for a 45-minute session based on the client's gross family income.  The intial session is usually 60 minutes followed by 45-minute sessions.


On a limited basis, reduced fee may be available when there is a hardship.

Insurance

Barbara E. Kaplan, MHDL is an in-network provider for a number of insurance companies, managed health companies, employee assistance programs (EAP), provider organizations, and networks which may include but may not be limited to:


Please note: An insurance company not listed above may have a managed care company that manages the mental health benefits of a member's particular insurance plan.  Barbara E. Kaplan, MHDL may be in-network with that managed care company.  To determine if she is in-network, the managed care company may be contacted directly, or if preferred, this counselor may be contacted at 704 333-1510 for assistance in determining if she is in-network.

 

Whether or not counseling services are covered by your health insurance or an employee assistance program (EAP) is determined by your health insurance plan or the Employee Assistance Program (EAP).  How much is covered is determined by your benefit coverage.


Information about health insurance coverage may be obtained by calling the insurance carrier’s telephone number listed on the insurance card and asking if an out-patient mental health benefit is a covered benefit for the insured and if there is also an out-of-network mental health benefit coverage for the insured.   IT IS IMPORTANT to write down the name of the representative  providing information, the time and duration of  the telephone call, and reference number for the call so that the call  may be tracked, if necessary, to validate information obtained for payment.  (Please note that some insurance companies use the words “behavioral health benefits” rather than “mental health benefits.”)   If there are these insurance benefits available, then it is important to ask the representative the following questions:

Payment

Cash, check and money order are the accepted forms of payment to be made at each session.


Cancellation Policy

If the client does not show for his or her appointment and has not notified the counselor with at least 24 hours in advance, the client is required to pay the full cost (or full allowable rate) of the session.  The only exception to this is if the managed care company or employee asssistance program pays for sessions scheduled and not attended but it is this counselor's experience that this is rarely the case.

  • Is Barbara E. Kaplan, MHDL or Barbara Kaplan, MHDL Incorporated in-network or out-of-network?
  • What are my outpatient mental health benefits for in-network and out-of network counseling?
  • What is the copay and co-insurance per counseling session for in-network counseling?
  • Do I have a deductible for outpatient mental health sessions for in-network and out-of-network counseling, and if I do, how much is it and the amount of the deductible that has been met?
  • How many counseling sessions does my insurance plan cover for my current plan year?
  • How much does my insurance pay for in-network and out-of-network counseling?
  • Is approval required from my primary care physician for in-network and out-of-network counseling? (If approval is required, please obtain it.)
  • Is authorization required for in-network and out-of-network counseling? If required, please request an authorization and write down the authorization number. Please bring the following to the initial counseling session: 1.) authorization number, 2.) telephone number, if called, to obtain the authorization, 3.) name of the company who provided the authorization, 4.) the name of the insurance company or managed care company representative spoken to, time of the call and duration of the call. Please be aware that some insurance companies use another company to authorize and manage mental health services and therefore it is very important to ask the representative who provided the authorization and other insurance information, what company the representative is representing.
  • Aetna
  • Aetna Behavioral Health
  • Aetna Resources For Living
  • ACI Specialty Benefits
  • Beech Street
  • Cigna - Evernorth
  • Cigna Behavioral Health
  • Magellan Health/Magellan Healthcare
  • MultiPlan
  • Mutual of Omaha
  • Optum
  • Private Healthcare Systems
  • United Healthcare

For Employee Assistance Program (EAP) benefits, please contact this program and write down the name and date of the representative contacted, the time and duration of the phone call and reference number for the phone call in asking the following questions:


  • Is Barbara E. Kaplan, MHDL in-network provider with my Employee Assistance Program benefit?
  • How many EAP sessions am I entitled to per calendar year?
  • Are my EAP sessions free? (If not, please ask the fee.)
  • To obtain an authorization, please request it, the authorization number and the effective dates of the authorization. Please bring the following to the initial counseling session: 1.) authorization number, 2.) name of the company who provided the authorization and the company's telephone number (even if obtained via electronic means).

PLEASE NOTE: If you would like the counselor to assist you in obtaining benefit information, please call 704 333-1510

to make this request.

Under the law, health care providers need to give patients who don't have  insurance or who are not using insurance an estimate of the bill for medical items and services.




You have the right to receive a Good Faith Estimate for the total  expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.


Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item.  You can also ask your health care provider, and any other provider you  choose, for a Good Faith Estimate before you schedule an item or service.


If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.


Make sure to save a copy or picture of your Good Faith Estimate.



For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/no surprises or call 1-800 985-3059


You have the right to receive a “Good Faith Estimate”

explaining how much your medical care will cost

Uninsured or Not Using Insurance

There is a new law in effect in 2022 called the No Surprises Act designed to protect individuals from being surprised by bills (costs) the individual receives for medical services.  Under this law, health care providers need to give to individuals who do not have insurance or who are not using insurance, a good faith estimate for medical services and items.  This law also provides a way to dispute the bill if the amount exceeds $400.00 or more than the estimate.  This is what is required of health care providers to post in their office and on the health care provider’s website: