Good Faith Estimate, Insurance, and Payment

Insurance Coverage for Therapy

Counseling is covered by most insurance plans and you do not always need to see an “in-network” therapist. If you have “out of network” benefits, a majority of the time, insurance will cover your sessions while only requiring a copay. This means you would pay for your session, and I will provide you with a Superbill, which is just a fancy receipt used by insurance to reimburse you.

How to contact insurance about In-Network Coverage.

  • Call the number on the back of your insurance card next to member services. (Sometimes Mental Health/Behavioral Health is a different number).

  • Tell the insurance rep that you would like to verify that Three Little Birds Counseling is an in-network provider for your plan. (TLBC NPI# 1548637796). Make sure your plan doesn’t have a “carve out” or another insurance covering the mental health benefits of your insurance policy.

  • Ask about your deductible. Have you met it? What are you responsible for before insurance begins to cover the sessions? At that time, what is your personal cost responsibility?

  • Ask if you have a copay.

  • Ask if you need a prior authorization.

How to contact insurance about Out of Network Coverage.

  • Call the number on the back of your insurance card next to member services. (Sometimes Mental Health/Behavioral Health is a different number).

  • Tell the insurance rep that you would like information on your out of network benefits. What is the deductible, copay, and where to send your superbill (receipt).

Three Little Birds Counseling LLC accepts all insurance outside of Medicaid and Medicare and is in network with:

  • Horizon Blue Cross Blue Shield (and affiliates)

  • Aetna (and affiliates)

  • Cigna (and affiliates)

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

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/nosurprises or call 800-985-3059.