What to expect, financially

The short version

• Ashley is in network with Hometown Health.
• Ashley works with Cigna as an out-of-network specialist provider. For Cigna members in California and Nevada, she requests a pre-authorization before services begin; if Cigna approves it, Cigna reimburses you at its in-network rate.
• For most commercial plans, she provides out-of-network care. She submits the claim electronically on your behalf, and any reimbursement is paid to you directly. What your insurer pays depends on its allowable amount and your plan’s benefits.
• For folks with Medi-Cal, Ashley partners with the Thrive Maternal Health Fund for grant-funded visits; see how to apply.
• For out-of-network and self-pay care, sessions are paid at the time of service. Credit cards, HSA cards, and FSA cards are accepted.

If you would like to talk about cost before anything else, a free 15-minute phone consultation is available: request one through the contact form.

Ashley Hanna-Morgan, LCSW, PMH-CCalifornia LCSW #66494 · Nevada LCSW #7719-CClient Notices

Insurance and courtesy billing

In network with Hometown Health

Ashley is in network with Hometown Health and currently paneled with them. What your plan covers, and what you pay, depends on your own Hometown Health plan, so please contact Hometown Health to confirm your eligibility, benefits, and expected costs before your first session; Ashley does not check eligibility or benefits.

Cigna

Ashley works with Cigna. For Cigna members in California and Nevada, she requests a pre-authorization from Cigna before services begin. If Cigna approves it, you pay the full session fee at each session, and Cigna reimburses you at its in-network rate. How much you get back depends on your plan’s benefits. Ashley is an ‘out-of-network specialist’ provider.

Medi-Cal: the Thrive Maternal Health Fund

For folks with Medi-Cal, Ashley partners with the Thrive Maternal Health Fund, which offers grant-funded mental health visits for postpartum mood disturbances and for perinatal grief and loss. Apply for these visits to work with Ashley here.

Courtesy billing for other plans

For every other insurance plan, Ashley is an out-of-network provider.

While I have transitioned away from billing insurance, many insurance plans offer out-of-network benefits to see a specialist and may reimburse you a significant portion of the session fee. You can verify your out-of-network benefits either by calling your insurance company or checking via your online member portal. See advice below.

Most major insurance plans allow me to electronically submit your out-of-network claim on your behalf, saving you the headache of having to navigate submitting these on your own. In this scenario, the client pays the full appointment fee, and I file claims to the client’s insurance company on your behalf. This informs your insurance to reimburse you directly.

Why out-of-network

Therapy is an investment of time, energy and money. I do quite a bit of work outside of our session time including reading, specialty training, consulting and preparing for our time together so you get the most out of your therapy hour. Structuring my practice as an out-of-network provider allows me to spend more time with clients, and less time on the phone trying to get reimbursed for months down the line. My promise to you is to always be fully present with you during the valuable time you set aside for this work.

How reimbursement works

1. Check your benefits

   Call your insurer or log into your member portal to confirm your out-of-network mental health coverage.

2. Attend your session

   Sessions are paid at the time of service.

3. Ashley submits your claim

   Ashley submits the electronic claim directly to your insurer. Any reimbursement is paid to you, based on your insurer’s allowable amount and your plan’s benefits.

Superbills from Ashley include the billing codes your insurance company needs, so you do not have to track down the right codes yourself.

Intensives and insurance

A 90-minute intensive is $300. Ashley submits one hour of the session ($200) to insurance, and superbills are available. Whether your plan covers any part of an intensive, and how much it reimburses, depends on your plan, so please check your benefits with your insurer.

Advice on interacting with insurance

Do you have a PPO? PPO plans provide the greatest flexibility in choosing your providers.

Questions that can be helpful to ask

• Do I have mental health benefits?
• How much does my plan cover for an out-of-network provider who is a specialist?
• Can I be seen within my in-network deductible because I need to see a provider who is a specialist?
• What is my deductible and has it been met?
• How many mental health sessions per calendar year does my plan cover?
• Is pre-authorization required from my primary care physician?

While you have them on the phone, clarify where to send superbills for reimbursement and/or how to follow up?

Practice policies

Payment

Payment is due at the time of service; credit cards, HSA cards, and FSA cards are all accepted. For out-of-network and self-pay care this is the full session fee. If you are using Hometown Health coverage, what you pay, such as your co-pay, depends on your plan’s benefits.

Sliding scale

I also reserve a few sliding scale slots for those who are having financial difficulties. If this is you, please reach out and inquire if I have reduced fee slots open at the moment.

Appointment cancellation policy

If you are unable to attend a session, please make sure you cancel at least 24 hours beforehand. Otherwise, you will be charged for the full rate of the session. Please be mindful that you are booking the appointment time slot, which means someone else cannot use it. Life happens, and I do my best to accommodate. We can always switch to telehealth or a phone call if need be. A partial appointment is better than missing an appointment, I think!

Support group registration

Because spaces are limited and your spot is held exclusively for you throughout all six weeks, registration fees are non-refundable. Missed sessions cannot be reimbursed or prorated.

Read the Support Group Guidelines & Consent.

Your right to a Good Faith Estimate

You have the right to receive a “Good Faith Estimate” explaining how much your care will cost. Under the federal No Surprises Act, health care providers must give clients who do not have insurance, or who are not using insurance, a written estimate of the expected charges for non-emergency services, on these timelines:

• A service scheduled 3 to 9 business days ahead: the written estimate comes within 1 business day after scheduling.
• A service scheduled 10 or more business days ahead: within 3 business days after scheduling.
• An estimate requested before scheduling anything: within 3 business days after the request.

Ashley can prepare your Good Faith Estimate through SimplePractice and send it to your individual client portal. To ask for one before you book, request it through the contact form or during the free 15-minute consultation.

Make sure to save a copy or a picture of your Good Faith Estimate. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-985-3059.