Service Rates

Video Transcription

[MUSIC PLAYING] Back for more fun, huh? OK, so this lesson will address establishing rates for counseling services. The topics will include service rates, sliding scale, additional fees. You'll need an established rate for all services. For example, different services include 45-minute sessions, 60-minute sessions, crisis sessions, and group sessions.

These rates must be consistent across clients and billed to everyone, all insurance companies and all self-pay clients. This means that you must ensure that all clients pay the required co-pays, deductibles, and co-insurances. Comping individuals part or all of their co-pay deductible or co-insurance is insurance fraud. The insurance company agrees to pay their end. And they expect that you are charging your end that they don't cover.

Dismissing a measly $5 co-pay from a client is bad practice. Even though insurance companies will reimburse at different rates the rate charged by you remains the same. So when billing a standard 60-minute session I bill the company $125 though they will reimburse me what our contracted rate is.

So it's super important that you discuss with the client potential responsibility for services provided ahead of time. Although I look up new clients' insurance coverage, I always tell them to contact their own insurance company and figure that out for themselves as well so that they have firsthand knowledge regarding co-pays, deductibles, and co insurances.

A sliding fee is a variable amount that is established by the client's ability to pay for services. This is typically used with individuals who do not have insurance and also cannot afford to pay the established rate. If you decide to use a sliding scale, you should Google search the Health Resources and Services Administration for the US Government's sliding scale fee chart.

If this fee scale is used, you will need to create a policy and have the client sign a form in order to enter into a contract with the client for the said amount. Counselors can charge several ancillary fees, such as charges for reports, charges for update letters on clients' treatment compliance, charges for sending records.

Most ancillary fees are not covered by insurance and will be billed directly to the client. Fees that are covered by insurance can be found in a list of CPT codes. Here's what we covered in this lesson, first, service rates, next, sliding scale, additional fees.