1. 1.General Information
   

2. 2.Accepting Insurance Payments
   

3. 3.How to Make A Payment Online & Fee Rates
   

4. 4.Fees, Reduced Fees & Adjusted Fees
   

5. 5.Flat Fees for Psychological Testing & Court Evaluations
   

6. 6.Controversies Over “Managed Care” Mental Health Insurance
   

7. 7.Thinking About Psychological Services In Stages
   

8. 8.Informed Consent & Privacy Forms
   

1. General Information

     This website page includes discussions about: 1) using mental health insurance to pay for psychotherapy and psychological testing; 2) how to afford psychological services in a recession; and 3) sliding scale and adjusted fees for those who need and want psychological services.

2. Accepting Insurance Payments

    

    Please be sure to call your your health care plan to determine if I am a preferred or participating provider in your network.

    However, even if I am not currently a “participating provider” or “preferred provider” for your plan, some plans may pay 50% to 70% of your bill if you choose your own “out-of-network” mental health professional, based on their “allowable rates” for such services. I will usually accept payments as an “out-of-network” provider and will complete the necessary forms and bills for your reimbursement.

    In some cases the companies may wish to “pre-approve” your first visit as a condition of reimbursement. Therefore, be sure to call and learn what the reimbursement policies are for your specific plan.

    Generally, preferred or participating providers are required to accept agreed fees from the insurance company and co-pays from the client. In contrast, out-of-network providers are often paid directly by the client who then submits for reimbursement to the insurance company. However, because I also conduct court and forensic psychological evaluations, sometimes these companies will not fully reimburse for such services, if they are not deemed “medically necessary.” So again, it is important to first call your plan and inquire about reimbursement and pre-approval policies.

    As discussed below on this webpage, if you do not have insurance coverage, you may not end up spending that much more to “pay out of pocket” for your own private mental health counseling, free of insurance company control and monitoring. Many health insurance plans may initially limit mental health coverage to only 8-16 sessions, require co-pays for each session and/or require that a separate mental health services deductible of a couple hundred dollars be met. By the time one factors in all of these “hidden costs” of “free” mental health coverage, the “free” mental health coverage doesn’t look that “free.” For clients who do not have insurance coverage, I will consider reducing my fee.    

3. Fees and How to Make a Payment Online

    Dr. Skoler’s full fees are $200 per hour for a 60 minute therapy or consultation session, or $175 for a 45-50 minute therapy or consultation session. Dr. Skoler’s full fees for court and forensic work are $270 per 60 minute hour, or a portion thereof. Adjusted or reduced fees may be available for both therapy/counseling and court/forensic work based on the situation, circumstances and need.

    You may pay online directly for psychotherapy, psychological testing or court evaluations using major credit cards, debit cards or PayPal. Check payments are accepted and need not be certified in most cases, depending on the time frame.

    Please select the webpage link below if you wish to make an online payment, or learn more about this payment option. Insurance plan payments and reduced, sliding scale fees are discussed below.

                                        *Make A Secure Payment Online*

4. Reduced Fees and Adjusted Fees

    HMOs and insurance companies often do not reimburse for court work, couples counseling, family counseling or psychological testing. Further, as discussed below,  these companies can, and do, place several restraints and constraints on therapy methods, the course and length of treatment, and reimbursements.

    Fee reductions may therefore be considered for psychotherapy, psychological evaluation and court services due to hardship, if multiple hours are billed, for lack of health insurance, or if you choose not to pay for mental health services through your insurance.

5. Flat Fees for Psychological Testing and Court Evaluations

    For psychological testing services, as well as for court testimony and forensic services, I often offer a “flat fee” to include client and attorney interviews, a review of records, psychological testing, a written court report, phone calls, e-mails, and one day of court testimony, if such testimony is likely.

    In this way, persons who have already retained an attorney will be able to anticipate a fixed fee for psychological evaluation and testimony services. For court and forensic evaluations it may be helpful to have your attorney call to discuss the scope and purpose of the evaluation. By talking to your attorney, I can understand exactly what kind of evaluation or report is needed.

6. Controversies Over “Managed Care” Health Insurance

    Many health insurance plans say they provide mental health services, however, limits are often placed on such coverage, and there are other “hidden costs.” First, there may be a separate deductible for mental health services. Next, there are often co-pays per visit. Besides the co-pay amounts, the insurance company may not pay for more than a few sessions, unless the therapist assigns a pathological diagnosis, and they may disallow more than brief “counseling” for a couple months.

    Such companies may also attempt to limit psychological testing, and may not pay for couples counseling, family sessions or court evaluations. And plans differ in their coverage, so it is important to confirm what services and payments they permit.

    Consequently, by the time the insurance company limits how many counseling sessions it will allow, charges co-pays, and/or has a deductible for mental health services, the actual average amount of money you are receiving for each counseling session may not sound very much like “counseling included.” Obviously plans differ, and some have better mental health coverage than others. However, in the long run, choosing your own therapist at a reduced fee, may not cost significantly more than “covered” services. This option has the other advantages of total privacy and no monitoring, reviewing or recording of your case by the insurance company.

    A controversial topic involves increasing pressures to view mental health problems as being fixable by a pill (medication), which is often clearly perceived as “cheaper” than psychotherapy services by health insurance companies.

    I believe that for certain percentages of people, medication, or a medication trial, may be worthwhile; however this should be a decision based on supporting diagnostic criteria, psychological test results, psychological assessment and the needs of the patient––not the result of pressure to take a pill to avoid more in depth psychological services. (Please see the introduction to the  “Psychiatric Meds” blog on this website for a discussion of these medication issues.)

    Because, in addition to tradtional therapy and testing, I conduct court psychological evaluation, please be aware that such services may not be “covered,” even for participating or preferred network providers.

7. Thinking About Psychological Services in Stages

    One way to think about psychotherapy and psychological testing is in stages, rather than as an all or nothing proposition. The trend today is towards psychotherapy and counseling being an implied agreement between therapist and client to address specific problems. This differs from old cliches about going into a psychoanalysis that went on “forever,” without necessarily relieving symptoms or addressing problems in the “here and now.” For further information, please see the “Therapy” webpage from the above Navigation Menu.

8. Informed Consent, Privacy & Ethics Forms

    If you choose to use my services for a consultation, for psychotherapy, for psychological testing, or for a court evaluation, I will ask you to fill out forms outlining your rights to confidentiality and my own obligations of ethical practice. I also use an ethical retainer agreement for court cases clearly stating payment policies, privacy laws and agreed fees. (No retainer commitment is required for consultations or therapy.)

    Except for certain limited legal exceptions, such as the need to report child abuse or a serious and credible risk of imminent harm to self or others by a patient who is refusing adequate mental health intervention, the privacy of psychological records are protected by law and can only be released with a specific written and signed consent form. The United States Supreme Court has affirmed the privacy of mental health records.

    All therapy, psychological evaluation and forensic/court report services must be formalized through a written agreement which clearly specifies due dates for psychological and court evaluations, fees, the nature of the contracted services, informed consents, releases of information and a commitment to professional ethics codes for psychologists. Information about your testing, records, treatment or any other aspect of your contact with my practice cannot be legally released to other persons without your informed written consent.