Practice Info & Billing FAQs

Practice Policies​

 

Appointments and Cancellations

Please remember to cancel or reschedule 24 hours in advance. You will be responsible for the entire fee if cancellation is less than 24 hours. This is necessary because a time commitment is made and held exclusively for you and it covers the expense of space/room availability for your session. If you are late for a session, you may lose some of that session time.

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1. The standard meeting time for individual therapy is 50 minutes. For some clients, a 40-to 45-minute appointment may be appropriate and will be discussed/recommended as needed.
    

Fees and Insurance Benefits

1. Fees are as listed below and range from $180-$195 for therapy sessions. 
    

2. Payment of fee is due at the time of the session and is charged to the credit card on file. Is it is the responsibility of the client to update the practice regarding changes in credit card information.
    

3. Wellshore Psychology is a private self-pay practice and you are responsible for payment at the time of service. However, you may be able to access your out-of-network insurance benefits. Please reference the “Knowing Your Insurance Benefits” form, which was sent to you as part of your intake packet (and copied below), for additional information. A superbill will be provided to you, which provides the necessary information to submit an insurance claim. Clients are responsible for confirming their benefits, making the clinician aware of any necessary documentation needed (e.g., preauthorization, treatment plan), and tracking their own insurance claims and payments.
    

Good Faith Estimate

1. You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who do not have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service.
    

2. 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
    

Contacting Your Clinician & Accessibility

1. If you need to contact your clinician between sessions, please message them through the Client Portal messaging feature, which protects your personal health information and is HIPAA-compliant. You may also text message, leave a voicemail, or email, though you acknowledge that these are not secure modes of communicating and the information may not remain confidential as it cannot be guaranteed others will not access or see it.
    

2. Please do not rely on client portal messaging, texting, email, or voicemail to communicate an immediate need or emergency as it is not guaranteed that the clinician has seen/heard the communication attempt. If your clinician is not immediately available, they will attempt to return your call within 24 hours. If a true emergency situation arises, the client agrees to call 911, call/text 988 (Suicide and Crisis Hotline), or go to your local emergency room.
    

3. In the event that you are out of town, sick, or need additional support, telehealth sessions are available and may be recommended if you are in the state of Maryland or other states participating in the PSYPACT interstate teletherapy compact (see below for participating states, districts and territories or click here). This may also be an option for those who work or attend school in another state besides their state of residence.
   
   Participating PSYPACT States/Districts/Territories: Alabama, Arizona, Arkansas, Colorado, Commonwealth of the Northern Mariana Islands, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming​​

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Billing & Knowing Your Insurance Benefits

 

Billing at Wellshore Psychology
At Wellshore, we understand that therapy and psychological services are an investment you make in your family’s mental health, wellbeing, and relationships. If you have questions about using your insurance, keep reading to explore some of our Frequently Asked Questions (FAQs) or reach out so we can help answer any questions you may have. It’s our goal to make this process as smooth as possible so that you can access the support and services you need.

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FAQs

1. How am I billed for services?
   Payment is due at the time of service and you will be charged through your card on file. You will also be provided a monthly superbill with all of the information necessary to submit to your insurance provider for reimbursement.
    

2. What is a superbill? 
   A superbill is simply an itemized invoice, or receipt, that outlines the services you received with your clinician. It is generated by our electronic health records system (SimplePractice) and sent to you automatically on a monthly basis. Superbills are important because they provide the detailed information that insurance companies typically need to evaluate claims and determine reimbursement eligibility and rates.
    

3. How do I use my insurance with Wellshore Psychology?
   At this time, we are private self-pay, which means we are out-of-network (OON) providers and cannot accept insurance. This is primarily because the insurance payout rate for mental health services are, unfortunately, not in line with current market rate. We also believe that clinicians and clients should together determine their line of care—not insurance companies who often dictate the number and types of sessions permitted. Many mental health providers in our region are OON for this reason.
   
   However, we do provide you with the superbill that you can submit to your insurance for possible partial reimbursement. If you are hoping to be reimbursed for services, we encourage you to call your insurance directly to inquire about your out of network coverage before beginning services with Wellshore. Please see the next section of this tip sheet for how to inquire with your insurance.
    

4. How do I submit my superbill?
   Most insurance providers have an online portal through which you can upload your superbill. Many of our clients find it to be a straightforward and quick process submitting it online. It’s also the most secure option, faster to submit than other options, and easy to track in case follow-up is needed. Mailing or faxing your superbill to your insurance company are sometimes other options as well.
    

5. What can I expect after I submit a superbill?
   Insurances typically have a time limit of 90 days or more (some up to 180 days) to submit your superbill for reimbursement. If you submit your superbill after this time limit, you risk losing any potential reimbursement. It can typically take your health insurance 2 to 4 weeks to process and payout your superbill. They will either pay you the amount outlined in your policy (see the second part of this document to determine the reimbursement amount) OR they will put this amount towards your deductible until it is met. Most clients are reimbursed directly from their insurance company with a check mailed to them. If your superbill is denied for some reason, call your insurance and request information about the denial. It is the client’s responsibility to track and follow-up on any claims.

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Checking Your Insurance Benefits

To determine your out-of-network insurance coverage, please check with your insurance provider by calling and asking the following questions.

 

Our provider information to have on hand when calling:

Wellshore Psychology

Laura Groft Ph.D., LLC

815 Ritchie Highway | Suite 206

Severna Park, MD 21146

EIN Tax Number: 99-2789677

 

Instructions and Q's to Ask:

1. Inform the representative you wish to know your out-of-network mental health benefits.

2. Ask if you have a Flexible Spending Account (FSA) or Health Savings Account (HSA) to use.

3. What amount of deductible must be met before reimbursements begin?

   • Amount of Out-of-Network Deductible:            

   • Amount of In-Network Deductible:

   • Deductible fulfilled to date:

   • Is there a maximum for out-of-pocket expenses?

4. Is there a maximum number of visits in a calendar/fiscal year?

5. Is prior authorization or a treatment plan necessary to begin?

   • If so, where should it be sent to?

6. Determine the amount of reimbursement you will receive:

   • Ask what the Usual Customary Fees (UCFs) are for the specific service codes listed below:

     • Initial Intake - $195 (90791)

     • Individual Psychotherapy - 45 minute session - $180 (90834)

     • Individual Psychotherapy - 60 minute session - $195 (90837)

     • Family Therapy Session - Patient not present - $195 (90846)

     • Family Therapy Session - Patient present - $195 (90847)

     • Psychological and Psychoeducational Testing - fee varies from $2900-3600 (96130, 96131)

     • Autism and ADHD-specific testing - $2200 (96130, 96131)

     • Developmental Evaluation - $2900 (96112, 96113)

   • What percentage of the UCF does the insurance company reimburse?

   • Reimbursement Equals: UCF for a Service Code  x  Percentage  =  Amount of Reimbursement

7. How are out-of-network insurance claims submitted for reimbursement? (e.g., insurance portal, website, mailing address)

8. Record the name of the insurance representative spoken with and the date you spoke.