Financial Information

Therapy sessions are one-hour long, and are usually recommended on a weekly basis for at least for the first month as you and your therapist build a therapeutic relationship and plan for treatment. After that, it is up to you and your therapist to determine a schedule that makes the most sense. Fees for sessions are:

Initial intake telephone call, 15 minutes – Complimentary
First session assessment, 1 hour – $175
Each subsequent session, 1 hour – $150
Late cancel/No-show – $150

These fees for each session are the same for individuals (children -> adults), families, or couples.

In-Network

Patchwork Therapy is a group comprised of some Independent Contractors and some staff therapists. Due to the nature of insurance contracts and due to the nature of Independent Contractors – not every provider is in-network with all of the insurance companies with which “Patchwork Therapy” is paneled. What this means when “in-network”, is that we are a preferred provider with your insurance company, and they will pay more of your fee for you than if we were out-of-network. As in-network providers, we bill the insurance companies the same amount listed in the therapy service fee above, but insurance will usually cover some or much of that cost so you pay less out of your own pocket. As in-networks provider, we will send the bill directly to the insurance company (submit your claim), and they will pay us directly for the portion they will cover. If you have any co-payment, co-insurance, or deductible, the insurance company will provide that information and then you would be responsible for that amount. These details are highly variable and are specific to each person’s insurance plan, so questions about your specific copayments and deductibles should be directed to your insurance company.

Out-of-Network

Patchwork Therapy can serve you as an out-of-network provider, however in this case you would pay for your therapy services at the time of your appointment, and then we provide you with documentation to give to your insurance company (superbill) and they reimburse you directly. We do not submit bills directly to the insurance companies if we are out-of-network, and full fee is charged to you at time of service.

Insurance Accepted at Patchwork Therapy, In-Network

Blue Cross Blue Shield PPO
Blue Choice PPO
Cigna
Aetna
United HealthCare/Optum (Andrea Hohf, Katy Howe - Only)

Sometimes therapists perform duties outside of your therapy session, which you will have requested them to perform. Charges will be incurred for these duties, including:

Consultation with other providers or professionals (school social workers, previous therapists, psychiatrists, etc). – $150 per hour, billed in 15-minute increments
Letter writing (Letters of Readiness for gender-affirming hormones or surgical procedures, emotional support animals, etc.) – $150 per hour, billed in 15-minute increments
Late Cancel/No-Show – $150
Process Records Request $150

Please be sure your therapist will discuss these fees at the time of the request, and you will receive a notice describing these fees at the time of intake.

Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.

Your Rights and Protections Against Surprise Medical Bills

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 protections 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:

The U.S. Centers for Medicare & Medicaid Services (CMS) at 1-800-MEDICARE (1-800-633-4227) or visit https://www.cms.gov/nosurprises for more information about your rights under federal law.

The Illinois Department of Insurance, Office of Consumer Health Insurance at (877) 527-9431.

Good Faith Estimates

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

*Under the law, healthcare 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 healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare 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 More Information

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).