Services/Self Pay Rates

• Individual Psychotherapy: $140 to $160 for a 55 Minute Session
• Family Relationship Skills Coaching: $160 for 55 Minute Session
• Couples Relationship Skills Coaching: $140 for 55 Minute Session

Notice to Clients and Prospective Clients:

Under the law, health care providers need to give clients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service, or at any time during treatment. 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, or how to dispute a bill, visit www.cms.gov/nosurprises.

Your Good Faith Estimate

For clients who are self-paying for services, a Good Faith Estimate will be provided of the cost for services for the remainder of the calendar year. This Estimate is in compliance with the No Surprises Act described above.

Included in a Good Faith Estimate will be the session rate, estimated number of sessions that may be anticipated in the current calendar year, and the total amount in dollars that could be owed by the patient during that calendar year. Good Faith Estimates are reissued each calendar year beginning the first week of January. Good Faith Estimates are subject to change depending on several factors: Progress in therapy; Therapy goals introduced or changed; Patient’s consent to participate in therapy.

Christina Unruh handles your financial responsibility by billing weekly for your session, and providing a superbill or a receipt for the amount paid. If at any time you would like to discuss or revise the Good Faith Estimate that has been provided to you, please reach out to Christina at christina@ncdbt.com or call at 919-306-1711.

Insurance

Christina Unruh Counseling PLLC is in Network with Cigna, Aetna, and BCBS –plans that are PPO/Employer-based.  Christina is not paneled with Healthcare.gov plans such as Blue Home, Blue Value, or Bright Health. Insurance is accepted for individual psychotherapy sessions. When your insurance is billed for psychotherapy,  the insurance will reimburse Christina Unruh, LCSW directly at a rate they have agreed upon. It is up to your insurance to decide what portion of Christina’s contracted fee that you are responsible for. It is the patient’s responsibility to contact their insurance company to determine their own financial responsibility. Christina asks that you contact the insurance before treatment begins to determine if a deductible must be satisfied before payment is rendered.

Why I do not Accept Insurance for Relationship Counseling

Relationship Counseling is not a provided benefit under insurance plans. While relationship difficulties are impactful on one’s mental health, the treatment of the relationship is not considered by insurance companies to be justification for a medical service.  In other words, treatment of a relationship lacks medical necessity, in so far as insurance companies view it. Insurance companies require therapists to sign contracts in which they agree to ONLY provide medically necessary services. A medically necessary service, as defined by insurance companies, is only given to a person with a mental health diagnosis.

Some therapists choose one person in the couple or family to assign a diagnosis, in order to satisfy the medical necessity requirement.  This person is considered the “identified patient” within the relationship. When this is done, the therapist has the burden of proving that the diagnosis of the identified person is the reason for the treatment. Furthermore, the therapist must prove that the diagnosis is being treated in each session, using clinical interventions that are tailored to the identified person’s unique clinical needs. If the therapist cannot prove these things, the therapist risks breach of contract and paybacks to the insurance company.

Relationship counseling provided by Christina Unruh, LCSW is offered to each partner/member equally.  Clinical interventions are chosen to assist all participants equally. Relationship Counseling does not focus on treating individual mental health symptoms, although many mental health symptoms can be reduced when we behave more skillfully in our relationships. It is strongly recommended that clients receiving relationship counseling participate in individual therapy as well to support mental health needs that arise or are ongoing. Referrals to therapists with openings are provided upon request.

Session Fees for Relationship Counseling are $140 per 55 Minutes. Payment is due at the time of service.

Forms of Payment

I accept cash, check and MasterCard/Visa as forms of payment. You may also use your FSA or HSA card as a payment method. I utilize PocketSuite software to allow a quick payment of copays or session fees  after our session ends. Your invoice and your receipt are instantly emailed to you. Payment for Copays is expected at the time of service.

Missed Appointment/Cancellation Policy

Appointment scheduling is done through email or phone.  I request that you give me as much time as possible if you need to cancel. Less than 48 hours advance notice is often enough time to fill your appointment slot. But less than 48 hours places a burden on me. You will receive an email reminder 2 days before your appointment. Please check your email daily. Call me immediately if you cannot attend an appointment. I will work with you to get you into an open appointment time during the same week.

If a session is missed or not cancelled at least 48 hours in advance,  the full session fee will be charged unless you are able to accept another available time in the same week. I make every effort to help you reschedule in the same week to avoid a cancellation fee. 

New protections for you: The No Surprises Act for Consumers

What are surprise medical bills?

If you have health insurance and get care from an out-of-network provider or at an out-of-network facility, your health plan may not cover the entire out-of-network cost. This can leave you with higher costs than if you got care from an in-network provider or facility. In the past, in addition to any out-of-network cost sharing you might owe, the out-of-network provider or facility could bill you for the difference between the billed charge and the amount your health plan paid, unless banned by state law. This is called “balance billing.” An unexpected balance bill from an out-of-network provider is also called a surprise medical bill.

What are the new protections if I have health insurance?

If you get health coverage through your employer, the Health Insurance Marketplace®, or an individual health insurance plan you purchase directly from an insurance company, these new rules will:

• Ban surprise bills for emergency services, even if you get them out-of-network and without approval beforehand (prior authorization).
• Ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for all emergency and some non-emergency services. You can’t be charged more than in-network cost-sharing for these services.
• Ban out-of-network charges and balance bills for supplemental care (like anesthesiology or radiology) by out-of-network providers who work at an in-network facility.
• Require that health care providers and facilities give you an easy-to-understand notice explaining that getting care out-of-network could be more expensive and options to avoid balance bills. You’re not required to sign this notice or get care out-of-network.

What if I don’t have health insurance or choose to pay for care on my own without using my health insurance?

If you don’t have insurance or you choose to pay for care without using your insurance (also known as “self-paying” for care), these new rules make sure you can get a “good faith” estimate of how much your care will cost, before you get care.