2716 Ocean Park Blvd, Suite 3075, Santa Monica, CA 90405 • Tel: 310-612-2998  •  Fax: +1-323-978-5416 © 2016 Pacific MFT

FEES & PAYMENTS

 

Pacific MFT Network is a direct pay service provider with the ability to accept insurance as an out of network provider for all PPO plans.  We have experience working with PPO insurance plans such as: Anthem Blue Cross, Blue Shield, Blue Card, HealthNet, United Healthcare, Cigna, Optum, Magellan, Value Plus and many others.  Unlike many other private practices, Pacific MFT will handle all insurance claims and follow up on any issues for you.  All that is expected from our clients is to pay their fee up front at the time of each session.  The insurance company will reimburse clients directly.

 

On a limited basis, we offer a sliding scale fee based on need and circumstances.  You can discuss sliding scale fees with your therapist during initial consultation. 

 

Payments are expected at the time service is rendered. Groups, workshops, and other special services require payment in advance of services being rendered in order to reserve your seat.

Forms of Payment Accepted

 

Payments can be made by cash, check, credit card, or electronically. Stripe, PayPal, and Venmo are our preferred choices for credit card and electronic payment transactions.

Please make all checks payable to Pacific MFT Network.

PayPal

Fees

Pacific MFT Network offers services with fees that vary depending on the type of service provided, the length of time for the service, and the expereince and expertise of the clinician.  We have the ability to provide services to a wide variety of clients by oferring a sliding scale fee based on need and circumstances. The usual and customary fees are noted below.

 

Individual Therapy
50-minute session

up to $300


Couples, Family, and Co-Parenting Therapy
50-minute session

up to $300

90-minute session

up to $450

In Home Therapy for Individuals, Couples, Families

50- minute session

up to $450


Groups

90-minute weekly session
Fees vary depending on the group

Average of $30 to $75 per person, per meeting


Pain Free Parenting Workshop 

90-minute session
$75 per person, per meeting


In-home Pain Free Parenting Workshop

2-hour session for up to 10 people

$600

PPO Out of Network Insurance

Pacific MFT Network is committed to providing quality treatment and service to all our clients. We offer the use of PPO insurance plans to help cover the cost of services as a benefit to our clients.  Pacific MFT Network is an out of network provider for all insurance plans.  We are not currently in network or on any insurance panels as a preferred provider.

Using insurance with an out of network provider can be confusing.  It is important to understand your benefit coverage as we offer no guarantee of benefits and coverage information. The only way to be fully informed about your benefits is to contact your insurance provider directly.  You can do so by calling the customer service number on the back of your insurance ID card.  You are responsible for paying any fees that are not covered by your insurance plan.

 

When we look up your benefit coverage, there is no guarantee of coverage or payment.  They will not verify the “allowed amount.”  The allowed amount effects the deductible and your per session fee.  What we can give you is an estimate of what you can expect. The allowed amount will only be communicated to us after the first claim has been submitted and processed.  At that time, we will have a better idea of what they will cover and how much your fee will be.

 

Our fee for service is generally $200 per session depending on the therapist you choose to work with.  For an out of network provider, most insurance companies will cover a portion of the session fee.  Each plan typically has a calendar year deductible and offers co-insurance once the deductible is met.  Your out of pocket payment per session will be the full fee ($200).  When your deductible is met, you can expect your insurance company to send reimbursement checks directly to you for the portion of the fee they will cover.   

 

Typically, the insurance company will only apply the plan’s allowed amount as credit toward the deductible even though you are paying full fee.  The allowed amount for your plan is currently unknown.  With the processing of the first claim, we will know what this amount is and how many full fee sessions you will need to pay to satisfy your deductible.

 

The deductible usually starts over every January, so at that time, if you have the same plan, you will be responsible for meeting the deductible and then the insurance company will cover the co-insurance portion of the allowed amount.

 

Pacific MFT Network will manage all the claims and billing processing with the insurance company for you.

 

If you have any changes in your insurance coverage, please communicate them to us as soon as possible.  A delay in setting up your new insurance may cause big billing issues that we would like to avoid.  

If you have any questions or want to discuss fees and insurance further, please feel free to contact our insurance billing department at billing@pacificmft.com or call 310-612-2998.