Brief Overview of Insurance & Checking on Insurance

All on-site services provided by Lepage Associates are insurance reimbursable. Also, if you wish, we will process your claims for you. In this climate of changing mental health insurance coverage, we strive to make psychological services accessible and affordable. We keep weekly open slots for new clients so that when you call you do not have to wait for weeks to get in. Our goal at Lepage Associates is to provide the highest quality mental health professionals* at a reasonable rate (for example, our 1-hour therapy rate is $125/hr, at the low end of the current average rate of $125-$150/hr). *All of our providers are doctoral level, clinical psychologists, with several years of experience, and a variety of specialty areas. We also have a select number of top-level doctoral trainees who have master’s level education and experience, and are completing their doctorates. At Lepage Associates you work with an experienced specialist/doctor.

Though we do not participate on panels, all insurance plans (except HMOs) will still reimburse for our services; in addition, plans very often reimburse the exact same amount whether you use someone on their panel or not, thus it will usually not cost you more to go out-of-network (see below for more in-depth information). For example, the NC State Health Plan reimburses 80% regardless of who you use. We have found that for most people it does not cost them more to go out-of-network, and we have found that when it does cost more to go out-of-network, the average difference is only $12-$15 more, a price many people are willing to pay to work with a clinician they like and trust. And though it seems “backwards,” we have also seen cases where it costs less to go out-of-network. Thus it is best to call your insurance company and get exact information regarding benefits (see below). We are very knowledgeable about insurance and can help you file claims and get reimbursed. The process is simple: you pay us for services rendered and your insurance company then sends the reimbursement check directly to you. We have claims forms for most major insurance plans at our office and can help you fill them out correctly.

We do take a limited number of NC Medicaid clients. Please call to ask about availability.

Checking on Insurance: We are happy to check on your insurance benefits for you. If you would like to check on your benefits for outpatient mental health yourself, we encourage you to click here for helpful hints in asking the right questions when you call your insurance company, to get the complete information that you need.

Additional Information on Insurance

Many people don’t realize that mental health benefits are reimbursed differently than general medical benefits. For example, if you pay a co-payment when you go to a medical appointment that does not mean you would pay the same co-payment for an appointment with a psychologist. Typically under their mental health benefits, insurance providers reimburse a percentage of what they refer to as an “allowable amount” or an “allowable fee,” and that percentage tends to be between 50% to 90% depending on your plan. Often this percentage remains the same regardless of whether you see an “in-network” or “out-of-network” psychologist. Sometimes insurance providers do use a co-payment for mental health services. There is a wide range of variability between plans.

We try to simplify this for you! Prior to your first appointment, if you wish, we will be happy to assist you in understanding your insurance benefits for mental health services by contacting your insurer, so that you will be clear about what portion of our services will be reimbursed to you by your insurance company. In this way you will know exactly what our services will ultimately cost you, after your insurance carrier has reimbursed you. There is no fee for this contact, regardless of whether you decide to keep your first appointment or not.

We encourage you to call and let us get this information for you! So that our focus can remain 100% on assisting clients with their clinical concerns, we do not participate as members of insurance panels, however, we also keep our fees quite reasonable to ensure that it will not cost you significantly more to go out-of-network. With our individual therapy fee at $125.00 per hour, we voluntarily keep our fee at the typical “allowable amount” of many insurance providers (and below the typical fee of many out-of-network psychologists), thus there is often little or even no difference in the ultimate cost to you between going in or out of network.

All charges are your responsibility from the date services are rendered, and payment for services is due in full on the date services are rendered. As health care providers, our relationship is with you and not your insurance company. It is your responsibility, should you desire reimbursement to yourself, to either process the claim with your insurance provider yourself or ask us to do it for you. We will be happy to process your claim for you, or help you process your insurance claims for reimbursement by providing you with a receipt of services rendered, which contains all of the information needed for an insurance company to process a claim, and by helping you fill out your claim forms.

You may, of course, also choose not to turn in your receipts for reimbursement, and simply utilize psychological services without informing your insurance company. We realize that some people prefer to bypass their insurance plans altogether because of constraints related to choice of therapist, number of sessions, treatment autonomy or concerns about confidentiality.

Initial Appointment Forms for Therapy and Evaluation Services

You may download the following forms, which are done in Word, should you wish to familiarize yourself with them before your first appointment. Therapy clients need the first TWO forms, and the 4th Consent form if it applies to your case; clients seeking any evaluation with the exception of custody need the first THREE forms, and the 4th Consent form if it applies to your case. Clients seeking divorce consult services to include: custody evaluation, parenting plan consult, divorce mediation/facilitation, communication skill building to prep for meetings, child specialist consultation, and/or parent coordinator services (coaching for cooperative co-parenting) please click here to go to Initial Appointment Forms for Divorce Services. MEDICAID clients please note you have a specific form for Medicaid, and must fill out: the fifth form in the list which is specifically for Medicaid clients and the 2nd form in the list which is the NC Notice Form; Medicaid clients should also fill out the 4th Consent form if it applies to your case; Medicaid clients do not have to fill out the 1st form in the list.

1. LEPAGE ASSOCIATES MENTAL HEALTH SERVICE AND FEE AGREEMENT

Information Concerning The Practice, Financial Arrangements,
Confidentiality and Patients’ Rights

2. NORTH CAROLINA NOTICE FORM

Notice of Psychologists’ Policies and Practices
to Protect the Privacy of Your Health Information

3. LEPAGE ASSOCIATES EVALUATION SERVICES AND FEE AGREEMENT

Information Describing What Each Evaluation Assesses For and Its Usefulness Plus What Each Entails, and Financial Arrangements

4. CONSENT TO RELEASE & EXCHANGE INFORMATION FOR CLINICAL SERVICES

By signing this form you allow us to exchange information with other professionals. For example, for minors it may be helpful for us to be able to speak with school personnel (teachers, school counselors). If the client has seen a previous therapist or had previous testing, this might be useful information for us to have. Any client who is presently using psychiatric medication should fill this out so that we may speak with the prescribing psychiatrist or practitioner. We must have a signed release form to be able to speak with anyone about your treatment.

5. MEDICAID CLIENTS: MENTAL HEALTH SERVICE AND FEE AGREEMENT

ONLY FOR MEDICAID CLIENTS. Information Concerning The Practice, Financial Arrangements, Confidentiality and Patients’ Rights. Medicaid clients use this form instead of the Lepage Associates Mental Health Service and Fee Agreement listed first in this list of forms; Medicaid clients do not also have to fill out the Lepage Associates Mental Health Service and Fee Agreement listed first in this list of forms.

Schedule of Fees

Clinical Services / Therapy:

   Individual, Couples, or Family Therapy Session (60 minutes): $125.00

   Individual, Couples, or Family Therapy Session (75 minutes): $155.00

   Individual, Couples, or Family Therapy Session (90 minutes): $185.00

   Group Therapy & Seminars per Session (90 minutes): $80.00

Clinical Services / Evaluation: (Please click on the above LEPAGE ASSOCIATES EVALUATION SERVICES AND FEE AGREEMENT for in-depth information on evaluations.)

   Psychoeducational/Educational/Academic Evaluations:

         . Full Psychoeducational Evaluation (full AD/HD diagnostic evaluation & LD evaluation,
         plus rule out influence of any possible mental health issues): $1,275.00

         . IQ & Achievement Evaluation (LD evaluation &/or Gifted evaluation): $975.00

         . AD/HD Screening: $650.00

         . IQ Testing only: $425.00

         . Achievement Testing only: $550.00

         . Readiness for Kindergarten Testing: $675.00

         . School observation: $165.00 per hour, port to port

   Psychological Evaluations:

         . Full Psychological Evaluation: $1,850.00

         . Abbreviated Psychological Evaluation: $1,275.00

         . Other psychological testing: $165.00 per hour

   Full Battery: (Combined Full Psychological & Full Psychoeducational): $2,550.00

   Substance Abuse Evaluations: $475.00

   Adult and Juvenile Forensic Evaluations:

         . Mental Health Evaluation/Risk Assessment:$1,850 or $1,275.00
         (depending on if full or abbreviated)

         . Competency to Stand Trial Evaluation: $250.00 per hour

         . The Insanity Defense evaluations: $250.00 per hour

         . Sex Offender Evaluations: $250.00 per hour

    Parenting Plans / Custody & Visitation Evaluations:

Click here for our tiered approach, which ranges in price from $200.00 per hour to $2,500 - $9,000 flat fees depending on services sought. (Please note our fees are kept at below the local average for parenting plans and custody evaluations, and are thus very reasonable.)

Click here for fees for DIVORCE CONSULT SERVICES.

Click here for fees for BUSINESS SERVICES.

If there is to be an increase in our fee, we will provide at least 30 days advance notice.  Regarding fees for returned checks, we will only pass along to you any fees that your bank charges us for the bounced check.

Information on FREE Initial Consultation:

We recognize when choosing a psychologist - whether for yourself, your family, or your company - it will be important for you to feel the professional you choose will be a “good fit.” Finding the right psychological services provider is a unique task, as this person will generally be addressing very personal issues with you, your family, or your employees. It can be daunting to worry as part of your quest to find the right psychologist to meet your needs, you may perhaps pay for one or more sessions with people who don’t turn out to be a good fit. As a professional courtesy, to help make your search for the right psychological services provider easier, we will not charge you for the initial session if you feel it is not a good fit. In fact, if your psychologist is not a good fit for you, he or she will be happy to talk with you about what you’re looking for, and give you the names of other psychologists that fit your description. If you decide we are a good fit and to use our services, only then will we charge you for the first session. If at the end of the first session you still have other appointments set up in your search for a psychologist, we will not charge you then, and will instead bill for the first session only if you decide we are a good fit and return to use our services. We hope this policy makes your search for the right psychological services provider a bit easier.