FAQs - Plumeria Counseling

FAQs


How do I get started?
  • Step 1: Fill out our make an appointment form online. https://www.plumeriacounseling.com/make-an-appointment/
  • Step 2: Plumeria will review your information and either call or email you to match you with the right clinician.
  • Step 3: You will have an intake interview with a therapist to set your treatment plan (50 min session)
Hours of Operation?

Admin/Reception/Office Management: 9 – 5 pm, via email and phone (onsite by appointment only)

Therapists: Offer appointments all day, including evenings and weekends

We are providing full services via video and phone, and some in person sessions (based on therapist availability).

What is the payment policy?

We ask for payment information upfront and charge after each session We accept cash, check or credit card (Visa, MasterCard or American Express)

Do you take insurance?

Our licensed providers are preferred & in-network with some or all of the following insurance plans. Coverage varies depending upon the therapist you wish to work with.

  • Aetna
  • BCBS
  • Cigna 
  • Humana
  • Traditional Medicare 
  • UHC/Optum  Select EAPs
I don’t see my insurance company listed. Why doesn’t Plumeria accept my plan?

Every insurance plan is different and the terms are set by insurance companies, not therapists. Some insurance companies limit the session length which most counselors feel is un-therapeutic. Some companies exclude therapy for certain issues. Our goal is to support our clients where they are in life and concerning the issues for which they are actually seeking help.

Most insurance plans will offer out-of-network benefits for their members to see providers who are not contracted with that particular company.  

We encourage clients to call the phone number on the back of their insurance card to better understand their plan details.

Questions you might ask the insurance representative:

What are my behavioral health benefits?

Are they subject to a deductible?

How much of my deductible has been met?

Will I owe a co-insurance?

Will I owe a copay at each visit?

What is my max out of pocket?

How much of my Max out of pocket has been met?

Is there a limit to the number of sessions?

Do I need an authorization number prior to seeing a provider?

Is the provider I want to see in-network?

COMMON INSURANCE TERMS


Plan Coverage: An insurance plan includes not only the terms which the member (you) and the insurance company agree to but also services and reimbursement rates for which a provider (your therapist) is covered. Insurance companies dictate the length of and how often members can attend counseling sessions. 

Every insurance company reimburses providers at different rates. When an insurance plan states that the provider will be reimbursed at 100% this means that the insurance company will pay the provider 100% of the rate the insurance company tells the provider they will accept. Providers do not set rates with the insurance companies. Insurance companies set the rates for providers. 

Deductible:  The deductible of your insurance plan is the amount you pay out of pocket prior to any insurance coverage kicking in. For example, if you have a $3000 deductible, you will pay all appointment fees for any provider you see (in-network providers) until you have paid at least $3000.  Not all plans include a deductible feature and not all services are subject to the deductible.

Co-insurance:  The co-insurance of your insurance plan is the portion of the payment due to the provider that you will pay. For example, if your co-insurance is 20% and the rate your insurance will pay is $150, you would owe $30 per visit. This amount is usually paid after the insurance company responds to the visit claim. Not all plans have a co-insurance aspect.

Copay:  The copay of your insurance plan is the per-visit amount you pay upfront. Not all plans have a copay aspect.

Max-out-of-pocket (MOP):  The MOP is the total amount your insurance company requires you to pay, after which they will cover 100%.  For example, if your MOP is $2000 and you have a copay of $20 per visit, once you have paid a total of $2000 per calendar year, you no longer owe the $20 copay per visit. Plan details vary.

In-Network vs. Out of Network:  The terms “in-network” and “out of network” refer to the participation status of a provider with a particular insurance plan.  

WOULD YOU LIKE TO PAY DIRECTLY? (NO INSURANCE)

Contact our office for more information about private pay rates. We accept Visa, Mastercard, and American Express. reception@plumeriacounseling.com

INSURANCE INFORMATION DISCLAIMER

***Clients are ultimately responsible for understanding their own insurance coverage. Plumeria Counseling Center can only provide clients with the benefit information we are given by their insurance company representatives. If this information is incorrect, Plumeria Counseling is not liable. Clients are responsible for all amounts due which are not covered by their insurance.

TELECOUNSELING AND VIRTUAL THERAPY SESSIONS

Taking part in virtual counseling sessions is easy, convenient, and does not require any technical expertise. You can access your session via smartphone, tablet, or PC. In most cases, you will receive an email or text reminder for your appointment from your therapist with a link to join the session.

The platforms our therapists use for virtual sessions are HIPAA compliant. To maintain your privacy, we suggest that you plan ahead, designating a quiet location, and use headphones if need be. Therapist reserves the right to reschedule any appointments that are not conducive to a therapeutic environment, so please plan ahead to be in a quiet, private location for your telecounseling appointment. Late cancellation charges or appointment charges apply in these cases.

Insurance Coverage for Telecounseling Appointments

The Licensed Therapists at the Plumeria Counseling Center are in-network and preferred with most commercial insurance plans. Many of these insurance plans cover virtual appointments. Please call the phone number on the back of your insurance card to determine if virtual sessions are covered under your plan.