CAS Counseling is IN-NETWORK with these health insurance plans:

• BCBS (including BCBSNC, Blue Options, Blue Advantage, Blue Home UNC Health Alliance, Anthem, and most BCBS plans nationwide)

• Aetna

• Anthem

• NC State Health Plan

• Federal Employee BCBS Plans

• Duke University Student Health Plan

• Cigna

• Medicare (Traditional Medicare only; not Medicare Advantage)

If we are in-network with your insurance company, you may still be responsible for a deductible, copay, or co-insurance.

If we are an out-of-network provider for your plan, you will be responsible for the full cost of your appointment. We will provide a statement, which you can submit to your insurance company for out-of-network reimbursement.  Some insurance companies allow us to establish a single case agreement, which would allow CAS Counseling to be considered in-network for you.  CAS Counseling will make every effort possible to establish this agreement to accommodate you.

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

When you get emergency care or get treated by an out-of-network provider at an  in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care – like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services: If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable  condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center: When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections  not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance  bill you unless you give written consent and give up your protections.

You’re never required to give up your protection from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network

When balance billing isn’t allowed, you also have the following protections:

You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.

Your health plan generally must:

• Cover emergency services without requiring you to get approval for services in advance (prior authorization).

• Cover emergency services by out-of-network providers.

• Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.

• Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact: North Carolina Social Work Certification and Licensure Board  336-625-1679

Visit https://www.cms.gov/files/document/model-disclosure-notice-patient-protections-against-surprise-billing-providers-facilities-health.pdf for more information about your rights under Federal law.

Payment is expected at the time of sessions unless prior arrangements have been made.

• 90791 – Diagnostic Evaluation $225

• 90837 – Individual Psychotherapy (53-60 minutes) $185

• 90834 – Individual Psychotherapy (38-52 minutes) $125

• 90832 – Individual Psychotherapy (16-37 minutes) $95

• 90846 – Family Psychotherapy, without patient present (60 minutes) $225

• 90847 – Family Psychotherapy, with patient present (60 minutes) $225

• 90833 – Additional 30 minutes $95

• 90853 – Group Psychotherapy (90 minutes) $60

• Consultation (90 minutes) $325

• Consultation (60 minutes) $250

• Coaching (45 minutes) $150

• Special Documentation and Out-of-Network Insurance Reviews will be charged in 15-minute increments at $185/hr.

Note: A charge of the full session fee is applied when appointments are missed or canceled with less than 48 hours’ notice. Missed sessions are not billable to insurance and you will be charged the full fee, not your copay amount.

Sometimes therapy is needed and there aren’t enough funds to cover the cost.

CAS has a strong belief in equal right to healthcare, regardless of financial means. To that end, each of our Associates offers a limited number of sliding scale session hours. While we occasionally have a waitlist for a sliding-scale spot, our counseling interns provide therapy exclusively at reduced rates, and therefore may be more likely to have openings.

If you are in need of a reduced rate, please specify this in your inquiry, so that we can best meet your needs.

Payment is expected at the time of sessions, unless prior arrangements have been made.

For a breakdown of our private pay fees, contact us.

NOTICE OF RIGHT TO RECEIVE A GOOD FAITH ESTIMATE OF EXPECTED CHARGES UNDER THE NO SURPRISES ACT:

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 one 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.