New Year and Insurance Reminders

As we move into the new year, Patchwork Therapy would like to send some reminders and information regarding insurance:

Some policies have a calendar year from 1/01 to 12/31. This means that starting January 1, deductibles reset to $0.00. This may increase the client responsibility portion up to and including $175 depending on the session fee.

If you have a new insurance policy for 2026 please send that information as soon as possible. If you have a new card please send a photo of the front/back of the card to wendy@patchwork-therapy.com. If you have any new information, even without the physical card, please send an email. This will help prevent delays in claim processing.

Contact your insurance company and be aware of your benefits. Some questions to ask:

Who and what will my policy cover?
What is my deductible?
Do I have a copay or coinsurance?
Am I in network with my provider?
What is the calendar year for my policy?

When calling your insurance company please keep record of who you spoke to and a call reference number. It is important that clients understand and know their benefits.

Insurance

Therapy Sessions, In-Network:

Blue Cross Blue Shield PPO
Blue Choice PPO
Cigna PPO
Aetna PPO
United HealthCare/Optum/UMR (Jennifer DeBosschere, Andrea Hohf, Greg Holich, Katy Howe, Julie Roubal, and Emily Wegenke - Only)

We also offer self-pay as an option. If you have any other changes for 2026 (address, email, credit cards on file, etc.), please email the Administrative Director at wendy@patchwork-therapy.com.

Not everyone understands insurance terminology, so, I have included some information below to help you better understand:

Deductible- the amount of money that the insured person must pay before their insurance policy starts paying for covered expenses.

Coinsurance- an insured individual's share of the costs of a covered expense (it usually applies to health-care insurance). It is expressed as a percentage.

Copay- a fixed out-of-pocket amount paid by an insured for covered services.

Out of Pocket maximum- a cap, or limit, on the amount of money you have to pay for covered health care services in a plan year. If you meet that limit, your health plan will pay 100% of all covered health care costs for the rest of the plan year.

This video is a great reference in regards to insurance: https://youtu.be/DBTmNm8D-84?feature=shared

Practice Policies

You will be receiving forms through your Patchwork portal via Simple Practice. Each client needs to re-sign the following documents: Consent to Treat, Practice Policies, Late Cancel/No Show policies, and Fees Not Covered by Insurance. If you pay out of pockets for services you will also need to sign a separate consent for that as well. These are yearly consent we need on file. We do understand that we see many clients in the same family and we need these completed for each client account.

Fees Not Covered by Insurance

Please be advised that there are times when fees will be assessed that are not covered by insurance. The following schedule, which is non-exhaustive, will outline products and associated fees.

Consultation with other providers or professionals (school social workers, previous therapists, psychiatrists, etc). – $150 per hour, billed in 15-minute increments
Letter writing – $150 per hour, billed in 15-minute increments
Late Cancel/No-Show for a therapy session – $150
Late Cancel/ No Show for Psychological Testing- $250
- Please know that we will charge a late cancellation fee if you or your child refuses to stay for therapy or are otherwise unavailable (such as in a public space or with others in the case of virtual sessions). Therapists protect this time and are prepared to do therapeutic work, and we are unable to bill insurance for time not spent having a session (as that would be insurance fraud). Please speak with your therapist if you have questions on this policy.
Process Records Request $150
Consultation with legal representatives (Lawyers, GAL, etc) or writing that will be submitted to court - $450/hr, billed in half-hour increments, one-hour minimum

Some of these activities will be done in conjunction with the others. For example, if we are asked to write a letter supporting specialty procedures or exceptions such as Emotional Support Animals or special housing arrangements at school, etc.), research is required in order to inform the writing. As such, billing will be completed for both research and writing, in this example.

*If your insurance company does not cover the cost of the sessions, or if your coverage is terminated, you will be responsible for payment in full at the time of service. We offer the benefit of verifying insurance coverage to the best of our ability; however, not all information can be obtained from our system check. Your insurance company will be the ultimate authority on your benefits. We highly encourage you to verify your benefits on your own prior to your first session.

Late Cancel/ No Show Policy

Therapy clients: Please keep in mind that our Late Cancel/ No Show policy charges are firm. If an appointment is canceled with less than 24 hours notice, the card on file will be charged the full session fee of $150 that was missed.

Testing Clients: Please keep in mind that our Late Cancel/ No Show policy charges are firm. If an appointment is canceled with less than 24 hours notice, the card on file will be charged the full session fee of $250 that was missed.