Insurance Information
Treating Your Mental Health Is An
Investment in You
Understanding your individual insurance information along with the cost of private pay therapy can feel confusing & overwhelming. That’s why we’re here to help you understand your insurance information, private pay services and Out-of-Network (OON) billing.
Understanding Your Insurance Information
& Out-of-Network Coverage
Follow the steps below to get the insurance information you need.
Step 1: Call your insurance company
You can locate the member services phone number on the back of your insurance card.
Step 2: Find out if you have out-of-network benefits
Ask the rep: “Does my plan include *out-of-network* benefits for mental health care? Specifically, for teletherapy/psychotherapy ?”
Step 3: Find out if you owe a deductible before the coverage kicks in
Ask the rep: “Do I have a deductible for out-of-network mental health services, and if so, what is the remaining amount I would have to pay before my health plan starts to reimburse me for any fees I pay out-of-pocket?” It is also good to ask when the plan restarts and the deductible resets (typically, plan deductibles reset in January)
Step 4: Find out how much your plan will reimburse you
Ask the rep: “What is the maximum amount my plan will reimburse for mental health service code 90837 with a Psychologist?” If the rep does not provide a clear answer, ask: “What is the maximum allowed amount for mental health service code 90837 with a psychologist, and what percentage of the maximum allowed amount will my plan pay?” (This percentage of the maximum allowed amount is the amount you would receive as reimbursement.) We hope this helps!
Cost of Therapy With
Fully Licensed Providers
Cost of
Ketamine Assisted Psychotherapy (KAP)
Affordable Therapy at Mind by Design:
"Pay What You Can" Program
» Before You Begin
Clients participate in a brief consultation phone call which allows them to set their own rate for services. There is no minimum and the rate is the decision of the client based on their financial needs. During this call, you will schedule your intake assessment and will also gain access to a Patient Portal Account.
» Intake Assessment
When working with a graduate level intern, the cost of services are set by the client during the consultation call with our client care coordinator
» Your First Session
Clients working with providers through our affordable online therapy program are provided with the care and dedication as all the clients at Mind by Design. Clients participate in their “intake “session”, which involves a 60-90 minute assessment to comprehend your needs and goals.
» Follow-Up Sessions
Together, you and your therapist will create a schedule that works to meet on a weekly basis.
Each follow up session is 50 minutes long and hosted on our HIPAA compliant tele-therapy platform through the Patient Portal.
Understanding Insurance Information
As licensed and pre-licensed psychotherapists, we are considered an out-of-network provider on most PPO insurance plans. Most clients are able to receive partial reimbursement from their insurance company for the cost of our sessions. Please see below for more information about how to seek reimbursement from your insurance company.
Why We decided to
Leave Insurance Panels...
PRivacy
- Your private information is not required to be submitted to your health record
- Privacy & confidentiality are upheld to the greatest extent
- Parents of children & teens in therapy do not have to worry about their child’s assessment or diagnosis impacting them negatively=
- You don’t have to worry that the Medical Information Bureau records your information (yes😳 – that’s real–😳 Member companies are required to submit a coded report of diagnoses & findings which may be “significant to the proposed insured’s health or longevity.”
Flexibility
- Sliding scales & concierge services may be offered, allowing access to services based on their individual income needs.
- Sessions can be unlimited and dictated by the client.
- Session can follow less traditional schedules, such as bi-weekly therapy
- Clients are not denied treatment if they need more than one service and can pick and chose which services are best for them
- Clients who not need to meet a diagnostic criteria to receive treatment. Any challenge, big or small, is treated in private pay therapy.
Choice & Voice
- Private pay clients decide on the frequency & duration of therapy instead of treatment being dictated by insurance companies. Only you & your therapist decide what you need.
- You won’t have to worry about changing therapists if your coverage, or therapist’s membership status changes.
- Insurance doens’t typically cover tele-therapy, specific diagnoses, and puts a limit on visits
- Insurance will inform clients of how many sessions they can attend, regardless of the clinical need.
- therapists and clients decide which treatment works best, where as insurance based practices must work within the covered services, regardless of the clinical need.
Clinical Outcome
- Many insurance companies provide payment only for certain approaches of therapy (short-term and problem-focused), which may lead to premature termination and transition out of therapy. This is not a treatment barrier when working with a private pay provider
- Many issues (such as martial problems, life stress, or personal growth) are not covered by insurance. This clinical need is not overlooked with private pay theray.
- Studies have shown that clients experience more positive outcomes when working with a private pay therapist, and feel more motivated and engaged in therapy.
Additional Insurance Information
Our goal it to decrease stress and anxiety, so we understand that the financial commitment to therapy is something to consider! We provide OON billing for clients who decide to bill their insurance for services. A “Superbill” can be provided to you for potential reimbursement of services. To know if you have to OON benefits, you can call your insurance company and ask about the process of receiving these benefits.
We understand that this can be confusing and frustrating and we can help talk you through it so that we can help you get the maximum benefits possible. Our clients that use their OON benefits find it very easy to submit the Superbill and get reimbursed (usually around 60-80% per session). Please contact us if you have more questions about accessing coverage, or would like to discuss the cost of services.
FAQ's about
Therapy at Mind by Design
Where are you located? I need a therapist near me
We are fully online, which means that your therapy sessions will be help via video call on our HIPAA compliant Platform. Anyone in New Jersey can access our therapy services
How do I get started as a new client?
New Clients can reach out to us directly via call, text or email here:
Does my insurance cover my visits?
We provide”Courtesy Billing” for clients who are using the Out-of-network insurance benefits.
Our Insurance Page shares a small blurb about Why We Left Insurance Panels
What are out-of-network benefits?
When using OON benefits, patients typically pay the full cost of the treatment upfront and then file a claim with their insurance company for reimbursement. The amount of reimbursement can vary depending on the plan, but it can sometimes be as high as 90%. Call your insurance to see if you have OON benefits or click here to call us and we can check for you!
Is Online Therapy As Effective As In-Person Therapy?
Online therapy is essentially face-to-face counseling, just conducted remotely. Studies show that tele-therapy is as effective as traditional counseling. Professional organizations and state governments recognize its benefits and have set regulations for it. However, like any therapy, its success in achieving your goals isn’t guaranteed. It’s important to discuss with your therapist whether tele-therapy is working for you.
How Should I Prepare for My First Session?
Showing up is all that you need to do! But if you really want to get the most out of session, it could help to take some time to think about what you want from therapy. It helps to write down your goals, questions you have or things that you feel are important to share.
Do you offer traditional talk therapy?
of course! though we have some unconventional therapy approaches, we are rooted in evidenced based practices. Talk therapy is a major player in the therapy room! See What we Treat and Integrative Services for more information
Is Virtual Counseling Suitable for Everyone?
Online therapy might not be as effective for individuals with chronic suicidal thoughts, severe trauma, significant mental health history, or those recently in intensive care. Such cases often benefit more from traditional, in-person counseling. We’ll help you decide if our online services are right for you during your intake and evaluation.
Can I Change Therapists If I'm Not Happy?
Yes, you can switch therapists to another provider within the practice, or we can provide you a referral if preferred. We want to ensure that your time and effort are well spent, and that you are getting the relief you need, that’s why we work collaboratively with each other in the practice, as well as outside therapists who we know and trust.
How Do I Know If Therapy Is Helping?
You should feel like you’re making progress. Signs it’s working include:
- Feeling comfortable talking to your therapist
- Your therapist respects boundaries
- You’re moving towards your goals
- You feel listened to
You’re doing better in life - Your self-esteem is getting better
What is your cancellation policy?
We ask that clients provide at least 24 hours notice in the event that they need to cancel to avoid the 50% cancellation fee. we understand that life happens and do our best to be flexible & reschedule.
What Geographic Areas Are Served?
Currently, we serve clients in New Jersey and are expanding to other states as telehealth laws evolve. While telehealth offers the convenience of attending sessions from anywhere, state laws require clients to be in-state during their session.
Is Online Therapy Easy to Use for Non-Tech-Savvy People?
Yes, it’s pretty simple to access sessions. You’ll need basic internet skills, such as opening and visiting the patient link sent to you via email. It’s similar to video chatting like Facetime or Zoom. We can also walk you through it on the phone the first time to ensure a strong connection
What Questions Should I Ask My New Therapist?
Feel free to ask anything. Some good questions are:
- How often will we meet?
- What do you specialize in?
- What experience do you have with my issue?
- What outcomes can I expect?
- How will I know I’m progressing?
- How long do you usually work with clients?
- How will we set my treatment goals?
What is the difference between associate therapists & fully licensed therapists?
Our Qualifications:
Our founder, Rebecca Sidoti, is a highly qualified, state-licensed therapist and supervisor with extensive training in anxiety related disorders and innovative treatment such as Ketamine Therapy. Mind by Design Counseling adheres to standards set by the our governing counseling boards.
To see each providers credentials, training and licenses, visit our “Meet the Therapists” Page to learn more.
- LAC/LSW are therapists who may practice clinical work under the supervision of a fully licensed therapist.
- LPC/LCSW are therapists who have completed the necessary clinical hours post-graduation under supervision and can practice clinical work independently.
Rebecca Sidoti, LCSW
OCD & Anxiety
Ketamine Therapist
VR Therapist
Caroline Goodhines
Learn more →
Molly Weaver
Learn more →
Denise Spivey
Learn more →
