Rates and Insurance
Counseling/therapy
Initial Session: $215
60 min session: $185
45 min session: $165
Sliding Scale
I do offer a discount for those for whom my full-fee is a barrier to treatment, and may slide as low as $110/session. Please ask if you'd like for me to send you a sliding scale formula.
Check with your HSA or other tax sheltered health savings to see if out-of-pocket payment might be covered. See, below, why paying out-of-pocket might be right for you!
Please bring payment to each session. I accept all major credit and debit cards, cash, checks and direct deposits.
Insurance I accept for Psychotherapy
- Aetna
- Anthem (Out-of-network)
- Blue Cross/Blue Shield (Out-of-network)
- Health EOS/Multiplan
- Medicare-Wisconsin
- Meritain Health
- Multiplan
- PHCS
- Quartz
- The Alliance
- UHC
- UMR
- Value Options
- Plans with out-of-network benefits
The questions below are offered as a guide for asking about benefits for "Out-patient Mental/Behavioral Health, Office Visit," should you call your insurance company. Find the member services number on the back of your card. Feel free to print this page for recording the answers. I am happy to help in this process in any way I can.
1 - Is Scott L. Fenton in or out-of-network? If "out," does my policy cover out-of-network mental health providers?
_____yes_____no (If the answer is no, you could see me and pay out of pocket, or see someone on their list).
2 - Is a referral or prior authorization required (this is rare)? If so, how do I get it?
____yes _____no
3 - What is the deductible for in/out-of-network providers? Write deductible amount here: __________________
4 - How much of this deductible has already been met this year? _________________
5 - Once the deductible has been met, how much is my co-pay/co-insurance? __________________
6 - Is there a limit to the number of sessions per year that I can use? ___________________
Paying out-of-pocket
There can be several good reasons for choosing to pay out-of-pocket (not using an insurance company). One of the most significant reasons that you should be aware of is that when you use insurance, the provider (me) must provide a diagnosis, and the insurance company decides whether or not this diagnosis is a “necessity” for treatment. Some policies also ask for “prior authorization,” which requires the therapist to provide even more details about your reason for seeking therapy. Once this diagnosis is given to the insurance company, that stays on your record and can at minimum cause you to have to explain the diagnosis at future doctor visits or future insurance companies, and at worse could result in you being denied coverage in some extraordinary circumstances, like worker's compensation cases. Hopefully, the healthcare changes brought about by the Affordable Care Act will continue to significantly reduce the incidence of people being denied coverage by insurance companies
Other reasons have to do with actual monetary expenditures. Many insurance plans carry a deductible, an amount you have to pay before insurance begins to take-over payments. I’ve seen these deductibles range from $250 to $3000, and they re-new every year. In addition, these same plans may only cover a percentage of the bill, anywhere from 90% to 40%. It is very possible that a course of treatment may come out of your own pocket entirely or mostly, depending on how many sessions you use in a year (e.g. In the case of a deductible, the more sessions you use, the less percentage of the whole bill you pay). If you consider that expense in addition to the drawbacks of having some details of your therapy on record, you may decide that it’s not worth it. At that point, you may decide to pay me out of pocket.
If paying the full-rate is a barrier to your treatment, I can then talk with you about a fee that is workable for both of us.
WANT TO KNOW MORE?
I want you to be matched with the best therapist for YOU. Why not give me a call or send me an email? I'm happy to talk with you on the phone for a brief, initial conversation, free of charge.
Scott L. Fenton, PsyD
Madison, WI 53716
- 608-628-3963
- 608-501-0978
- scott@fullbeingness.com