Frequently Asked Questions
Does Healgood accept insurance?
At Healgood, we value transparency and want to ensure you are fully informed about your payment and reimbursement options for the services we provide. Healgood’s clinicians are out-of-network providers, meaning we do not bill insurance companies directly. Currently, we are accepting private pay clients (we do accept HSA and FSA credit cards - see more below) and are happy to provide monthly receipts, often called “superbills” by insurance providers, that you may submit to your insurance for reimbursement for out-of-network benefits — with the exception of Medicare, if you have Medicare, please read more below. Know that some insurance companies may not reimburse for services provided by a LPC Associate. Please contact your insurance company for information regarding your out-of-network benefits and reimbursement for counseling services. We cannot guarantee any coverage by insurance.
Healgood is not on insurance panels by choice. There are multiple reasons for this:
1) Insurance does not recognize levels of specialization or training quality in providers;
2) Insurances require a formal diagnosis to be kept on record and may request confidential medical records to prove need for services, all of which compromise client privacy;
3) Insurance companies often restrict sessions, which may not be in the client's best interest;
4) Insurances cause much paperwork, delayed payouts to providers, or may refuse or revoke payouts to providers that leave clients with unexpected account balances with their provider.
If you prefer to use an in-network provider, please contact your insurance provider as ask for a list of in-network mental health providers in your area.
Important Notice to Medicare-Eligible Patients
Opt-Out Status: At Healgood, we value transparency and want to ensure you are fully informed about your payment and reimbursement options for the services we provide.
Medicare Opt-Out Status: Please be advised that Healgood and all its providers have opted out of Medicare. This means that:
- We do not bill Medicare for the services we provide.
- Medicare will not reimburse you for any payments made to us for our services.
Private Contract Requirement: If you are a Medicare-eligible patient and wish to receive services from us, you agree to the following:
- You will pay out-of-pocket for all services provided by Healgood.
- Neither you nor Healgood will submit claims to Medicare for these services.
- You accept full responsibility for the payment of our services, with the understanding that Medicare will not reimburse you.
Why We Opted Out: Our decision to opt out of Medicare allows us to provide more personalized and flexible care without the constraints of Medicare regulations. We believe this enhances the quality of the services we offer.
Your Options: We understand that this decision may impact your payment options. If you prefer to use your Medicare benefits, we can provide a list of Medicare-participating providers to whom you can be referred for services covered by Medicare.
Can I seek Out-of-Network Reimbursement?
Yes. If you'd like to try utilizing out-of-network insurance benefits to help offset the cost of therapy, Healgood can provide you with a receipt of services called a ‘superbill.”
Every insurance plan is different so contacting your insurance carrier will be the best way to determine your out-of-network benefits and coverage options. If you find out you have out-of-network benefits you want to use, please let us know so that we can provide you with a superbill.
Below is guidance for how to communicate with your insurance carrier to determine your benefits/options. When speaking to an insurance representative, be prepared to write down their answers to the questions below:
Step One: Call the member services number on the back of your insurance card and request to talk to a member service representative.
Step Two: Listen to your eligibility and benefits summary (if there is one).
Step Three: Make sure to get answers to these specific questions, and write down the responses to reference later:
Does my plan cover outpatient mental health counseling/therapy?
Does my plan offer any out-of-network benefits for mental health counseling? (This means any benefits or coverage for seeing a provider who does not take your insurance).
Do I have a deductible to meet before out-of-network mental health services are covered? If yes, how much is the deductible? How much has been met already?
Once I satisfy my deductible, what percentage/amount of coverage can I expect to receive for the cost of out-of-network mental health services? (For example: Will they reimburse you 60% of your session fees? 50%? Less/More? Plans typically reimburse a percentage of the total cost.)
What CPT Codes (service codes) are covered? Examples:
90791 - Initial Biopsychosocial Intake Assessment
90832 - Individual Psychotherapy, 16-37 minutes
90834 - Individual Psychotherapy, 38-52 minutes
90837 - Individual Psychotherapy, 53+ minutes
90846 and 90847 - Family Psychotherapy
90853 - Group Psychotherapy
Are there any limitations to this coverage? (Session limits, yearly limits, telehealth versus in-person meeting stipulations, etc.)?
How can I file claims for therapy reimbursement? Is there an online portal where I can file my claims? Is there a claim form I need to complete in addition to submitting my superbills?
Step 4: Write down the representative's name and a reference number for the call. This information will be necessary if you ever need to dispute a rejected claim.
Do you accept HSA or FSA cards?
Yes, we accept major credit cards (including FSA or HSA cards), cash, or check. We require payment at the time of each appointment or online through the our secure Client Portal. If using a FSA or HSA card, we recommend reaching out to your insurance carrier to ensure that mental health services are a covered charge on the card.
Do you offer sliding scale or reduced rates?
Yes, we do provide a limited number of sliding scale or reduced rate options. If our fees are not workable for you, please inquire about a reduced rate. Learn more about our sliding scale policies here. If finances are a barrier to mental health care for you at this time, please know that there are free or low-cost options. If you have health insurance, start by contacting your insurance provider and ask about your behavioral/mental health coverage options. They may have a list of therapists who accept your insurance. If you do not have mental health insurance benefits and/or are paying out-of-pocket, some low-cost counseling options in the Austin area include:
Additional Resources via Texas 2-1-1 | Resources in Texas for counseling and mental health care as well as food, health, housing, employment, childcare, and more visit the website https://www.211texas.org/ or Call 2-1-1
Do you accept any grants or work with any financial assistance programs?
Healgood is an authorized Texas Education Agency (TEA) Supplemental Special Education Services (SSES) Program Provider.
If you plan to utilize an SSES grant to cover services, please note that all policies outlined in our standard informed consent apply, supplemented by the following provisions:
1. SSES Compliant Invoices: An SSES-compliant invoice will be issued at the time of service, fee due, or purchase. It is imperative that clients/parents/guardians submit this invoice via the ClassWallet platform promptly upon receipt to ensure timely provider payment.
2. Financial Responsibility: Clients/parents/guardians will assume financial responsibility in the event that SSES fails to issue full payment within 5 business days. An alternate form of payment in the form of an active Credit Card, must be kept on file to facilitate prompt payment in such instances.
For additional information regarding the SSES program, please visit the TEA's webpage at: https://tea.texas.gov/academics/special-student-populations/special-education/supplemental-specialeducation-services-sses
What is your cancellation policy?
Clients can cancel or reschedule up to 24-hours in advance without penalty. However, clients will be billed for the full fee session rate with late or no notice (no show).