Sliding Fee Scale & Superbills

Sliding Fee Scale

Clinicians at OCRSH offer a Sliding Fee Scale for clients experiencing financial hardships. The Sliding Fee Scale is used to determine the cost per session based on the client’s annual income. This allows for clients to still have access to therapy despite financial barriers. The number of clients a clinician can accept under the Sliding Fee Scale is limited to 10 per clinician, and is on a first come first serve basis. To find out if a certain clinician is accepting SFS clients, please reach out to them via email, which is listed on our scheduling page. If an individual chooses to utilize the sliding fee scale option, their income will need to be verified by providing tax documents at the beginning of treatment and on a 6 month basis following the initiation of treatment.

Please note: The rate for sliding fee scale is determined based on the individual income level of individual clients and combined income levels of couples/relationship therapy clients. Please also know that we do NOT allow clients to utilize the Sliding Fee Scale and submit superbills to their insurance companies for reimbursement. Sliding Fee Scale is reserved for clients who do not have the option of submitting a claim to their insurance company for reimbursement. See below for more information on superbills.

 

Superbills 

While we are no longer in network with most insurance companies, we can provide a copy of a "Superbill '' that is sent from the client portal to your email. These can be submitted by you to your insurance company for potential reimbursement or to go toward a deductible. Reimbursement is entirely up to the discretion of the insurance company and OCRSH has no power in the determination for reimbursement. We highly suggest that all clients contact their insurance company prior to scheduling their session to ask about out of network services and the reimbursement process.

Why Are Some Clinicians Private Pay Only?

It is common for clinicians to opt for private pay only rather than be partnered with an insurance company, especially when a clinician specializes in helping clients with sexual issues. Many insurance companies can refuse to pay for services rendered because they may not deem services as "medically necessary". This is largely due to the ways in which sexual health has been disregarded in our healthcare system. Unfortunately, some insurance companies will partner with clinicians but will breach contract and refuse to pay the clinicians for their services after the services have been rendered. This can happen at any unforeseen time and results in difficulties for the client, clinician, and practice as a whole. As per our policy, clients are responsible for the complete cost of service should their insurance company refuse to reimburse the clinician for their services.

At OCRSH we believe that having a happy, healthy, and even joyful relationship with one's sexuality is not just "medically necessary", but essential to the overall wellbeing of each and EVERY human being. We also believe that mental health treatment should be accessible to ALL and not just some. As a result, we have made the decision to switch to private pay as a practice (with the exception of a few clinicians who take Caresource/Medicaid) and to offer the option of being sent a Superbill for clients to submit to their insurance company OR for clients to utilize the Sliding Fee Scale option that is based on income level.

Sliding Fee Scale for All Clinicians Except Dr. Ashley

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*Please note--Regardless of income bracket, initial assessments are billed at $160 for 50-minute, individual sessions $175 for couples' initial, 50-minute sessions*. Additionally, the provider reserves the right to limit the number of sliding fee scale cases to 10 clients at any given time. The provider also reserves the right to alter the fee schedule as deemed appropriate based on any financial changes in the client’s life. Any changes will be addressed candidly with the client(s).

Sliding Fee Scale for Dr. Ashley

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*Please note--Regardless of income bracket, initial assessments are billed at $185 for  80-minute, initial individual sessions and $295 for couples' initial, 80-minute sessions* Additionally, the provider reserves the right to limit the number of sliding fee scale cases to 10 clients at any given time. The provider also reserves the right to alter the fee schedule as deemed appropriate based on any financial changes in the client’s life. Any changes will be addressed candidly with the client(s).