Insurance, Fees & Practice Policies

We believe transparency is an important part of care. Below you’ll find details about insurance, fees, and practice policies designed to support a consistent, respectful experience for everyone involved. Taking time to review this information can help ensure there are no surprises as we move forward together.

Insurances Accepted

We work with both self-pay and insured patients and are currently in network with several commercial insurance plans, including:

  • Cigna/Evernorth

  • Aetna (billed through Alma)

  • Highmark

  • United Healthcare/Optum

  • UPMC Health Plan

  • Blue Cross Blue Shield.

  • Copays are collected on the day of your scheduled appointment using the credit card on file. For most insurance plans, claims are submitted directly to your insurance carrier on your behalf, and if your visit is covered, you will not be responsible for our full self-pay rates.

    After your insurance processes the claim, an invoice will be sent for any remaining deductible, coinsurance, or other patient responsibility as outlined by your policy.

    Patients are responsible for understanding their insurance coverage and for notifying our office of any changes to insurance plans or coverage so claims can be submitted accurately and within required timeframes.

  • Aetna insurance plans are billed through our third-party billing partner, Alma. When this applies, patients are notified of the billing arrangement before their initial appointment so expectations are clear from the start.

    For patients using Alma, enrollment in Alma’s billing system is required to receive care, and a valid credit card must be maintained on file. After intake, patient information is entered into Alma’s secure system, and Alma will contact the patient directly to collect insurance details, verify active coverage, and determine any applicable patient responsibility. Appointment confirmations, invoices, and policy updates are communicated by Alma, and any required auto-payments are processed following sessions in accordance with the patient’s insurance plan.

    Alma uses its own fee schedule for covered services and does not accept third-party payment systems such as InstaMed. All billing-related communications come directly from Alma, and patients may be contacted by Alma regarding coverage verification or policy updates as needed.

  • Self-pay is available for patients who do not have insurance, as well as for insured patients who choose to pay privately rather than use insurance benefits. Patients without insurance are responsible for our standard fee schedule, with payment due at the time of service unless alternative arrangements are made.

    Insured patients may elect to self-pay by choice, even when coverage is available. Choosing this option means services are not billed to insurance, and self-pay amounts typically do not apply toward deductibles or out-of-pocket maximums unless permitted by the insurance plan. This option is selected voluntarily after reviewing the terms and having any questions addressed.

    To use self-pay, a Self-Pay Election form must be completed prior to the first appointment, and payment is due at the time of service unless otherwise arranged. If a patient wishes to change from self-pay back to insurance billing, written notice is required so billing can be updated appropriately.

  • To help keep billing simple and timely, we ask all patients to maintain a valid credit card on file. This card may be used to cover copays, coinsurance, outstanding balances, no-show fees, or any patient responsibility identified after insurance has processed a claim.

    Charges are applied only after services are provided or when a balance is due. Payment for completed services is considered final, and patients are responsible for any fees related to declined transactions. By keeping a card on file, patients confirm they are authorized to use the card and understand that this authorization remains active unless updated or revoked in writing.

  • Some services are not covered by insurance and are billed separately. These may include administrative services such as medical records requests, forms or letters, and disability-related paperwork. Legal and court-related services, including preparation, appearances, and required travel time, are also not covered by insurance due to the additional time and resources involved.

    Appointments canceled with less than 24 hours’ notice, or missed appointments, are subject to a $75 fee, as insurance does not cover missed or late-canceled visits.

Practice Policies

These policies are meant to help set clear expectations and support a respectful, consistent experience for patients and providers. We encourage you to review the information below so there are no surprises, and everyone feels informed moving forward.

  • We are committed to providing a safe, respectful, and supportive environment for patients, providers, and staff. Mutual respect is essential to effective care, and we ask that all interactions—whether in person, by phone, or through electronic communication—remain courteous and appropriate.

    Behavior that is threatening, aggressive, harassing, discriminatory, or otherwise disruptive is not tolerated. This includes inappropriate language, repeated boundary violations, or misuse of communication channels. When concerns arise, we may address expectations directly and, if needed, adjust the treatment plan to maintain a safe and respectful care environment. In some cases, continued behavior concerns may result in discharge from the practice.

    These guidelines are in place to support a professional, welcoming space where care can be delivered thoughtfully and consistently for everyone involved.

  • Consistent attendance helps support effective care and allows us to offer appointments to patients who need them. Patients are responsible for keeping track of scheduled appointments, even when reminder notifications are sent.

    If you need to cancel or reschedule, we ask that you notify our office at least 24 hours in advance. Appointments canceled with less than 24 hours’ notice, or missed appointments, are subject to a $75 fee, as insurance does not cover missed or late-canceled visits.

    Repeated late cancellations or no-shows may prompt a review of treatment needs and readiness to continue care, and in some cases may result in discharge from the practice. Medication refills are not provided following missed appointments until the patient has been seen by their provider.

  • Telehealth sessions are offered using secure, HIPAA-compliant platforms and are intended to increase access to care while maintaining clinical quality and safety. Patients must provide their current location and a working phone number at each session and participate from a private, distraction-free environment. For safety reasons, telehealth sessions may not take place while driving or operating a vehicle. Telehealth services are subject to licensing requirements, meaning providers can only see patients who are physically located in states where they are licensed. In situations where safety concerns arise, appropriate emergency protocols may be initiated.

    Telehealth care depends on reliable technology and active patient participation. Patients are responsible for ensuring privacy, minimizing interruptions, and remaining fully available for the duration of their scheduled appointment. While providers make every effort to reconnect if technical issues occur, full session fees may still apply when disruptions are related to patient technology, connectivity, or availability. Backup phone communication may be used when necessary, though complete confidentiality cannot be guaranteed with any electronic communication.

  • Some psychiatric medications are classified as controlled substances and are subject to additional state and federal regulations to support patient safety. These medications are prescribed thoughtfully and only when clinically appropriate, and they require closer monitoring than non-controlled medications. Examples include certain medications used to treat ADHD, anxiety, and insomnia.

    Controlled medications require an in-person visit before they can be started, as well as at least one in-person visit every 364 days to continue prescribing, in accordance with applicable regulations.

    Controlled medications must be taken exactly as prescribed and should not be increased, decreased, or stopped without first discussing changes with the prescribing provider. Combining controlled medications with alcohol, narcotics, muscle relaxants, or other controlled substances can be dangerous. Self-adjustment, misuse, or non-compliance may result in changes to the treatment plan or discharge from the practice.

    Refills are not provided early, and lost or stolen controlled medications cannot be replaced. Dosage changes are made only during scheduled appointments. If a patient transfers care while already prescribed controlled substances, continuation is not automatic; providers complete an independent assessment and determine appropriate treatment based on clinical judgment and safety considerations.

    Medications Prescribing is monitored through required prescription drug monitoring programs, and patients are expected to fully disclose any controlled substances obtained from other providers or emergency departments while under our care. Drug screening may be required before starting controlled medications and periodically throughout treatment. Abnormal results or failure to comply with monitoring requirements may result in discontinuation of controlled medications or discharge from the practice.

    These guidelines are in place to support safe, responsible prescribing and high-quality care for all patients.

  • Disability and FMLA documentation is completed for established patients who meet eligibility criteria based on length of care, recent visits, and ongoing treatment compliance.

    Long-term disability or SSI forms require a minimum of six months of care, while short-term disability or FMLA forms require at least three completed visits and a recent appointment within the past 30 days.

    Forms are completed at the provider’s discretion and may take up to 14 days to complete. Depending on the length and frequency of requested documentation, fees may apply. While we provide medical documentation, we do not determine disability eligibility or guarantee approval.

  • We use electronic communication tools to support care coordination and share general information, while prioritizing privacy and confidentiality. Professional social media accounts are used for education and advocacy only and should not be used for treatment-related communication. For privacy reasons, we do not accept friend requests on personal social media accounts, and interactions on public platforms may compromise your confidentiality.

    For secure communication, patients are asked to use the Spruce app or the patient portal. Email is not used for clinical communication due to security and confidentiality concerns, and any electronic messages sent to our office may become part of the medical record. Standard SMS text messaging is not secure and should not be used for sensitive information; Spruce provides HIPAA-compliant, encrypted messaging and should be used for all text-based communication.

    Electronic communication is not a substitute for appointments and should not be used for emergencies. Messages are reviewed during business hours and addressed as soon as possible, with urgent concerns prioritized when appropriate. For life-threatening situations or emergencies, please call 911 or go to the nearest emergency room.