Brilliant Sky Counseling

Rates & Insurance

Do you take insurance?

Loraine Kern does not accept insurance for a variety of reasons.

If you have any “out-of-network benefits” for counseling, your sessions may be covered in full or in part by your health insurance or employee benefit plan. Upon request, you will be provided with a “superbill” with the codes you may need to receive reimbursement from your insurance company. It is your responsibility to submit your receipts and obtain any reimbursement from your insurance company.

Payments are due at the time of service. We accept – Check, Cash or Credit Card (Visa, Mastercard, American Express and Discover).

What are your rates?

$180 per 60 min

$270 per 90 min

$360 per 120 min

Payments are due at the time of service.

Health Savings Account, Check, Cash or Credit Card (Visa, Mastercard, American Express and Discover).

Cancellation Policy

I require 24-hours’ notice for all cancellations. Failure to cancel within that time frame results in a charge of your full session fee.

Good Faith Estimate

Under Section 2799B-6 of the Public Health Service Act, health care providers and health care facilities are required to provide individuals who are not enrolled in an insurance plan or a Federal health care program, and not seeking to file a claim with their insurance via superbill or via an in-network provider, with a “Good Faith Estimate” if expected charges at the time of scheduling health care items and services.

A “Good Faith Estimate” explains how much your medical and mental health care will cost over the period of time you are in treatment. Under this law, health care providers need to give patients who don’t have insurance or who are choosing not to use their insurance an estimate of the expected charges for medical services, including psychotherapy services.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

NO SURPRISES ACT

YOUR RIGHTS AND PROTECTIONS AGAINST SURPRISE MEDICAL BILLS

(OMB Control Number: 0938-1401)

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.

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.