Insurances & Payments

Options for Treatment Coverage

Self-Pay Office Visits

Individual or Couples Therapy Session Up to 45+ minutes: $150.00

Good Faith Estimate Notice

Harmony Counseling Center, LLC

1/1/2022

Notice to clients and prospective clients:

Under the law, healthcare providers must give clients who don't have insurance or are not

using insurance an estimate of the expected charges for medical services, including psychotherapy services.

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency

healthcare services, including psychotherapy services. You can ask your healthcare provider and any other

provider you choose for a Good Faith Estimate before you schedule a service or at any time during treatment.

If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.

Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate or how to dispute a bill,

see your Estimate, or visit www.cms.gov/nosurprises.

Healthcare Savings Accounts (HSA/Benny Cards) are accepted for all services and

maybe the desired form of privacy payment.

Payment is required at the time services are provided.

Payment accepted by:

American Express, Cash, Check, Discover, Health Savings Account, Benny Cards, Mastercard, Visa

Harmony Counseling Center does not participate with Medicaid or Medicaid-managed care organizations (such as HIP).

Many providers agree to see Medicaid members for cash and bypass Medicaid.

However, our policy is that we will not accept Medicaid members who agree to pay cash.

This is to comply with 405 IAC 1-1-3 (I), which states that providers can only accept cash payments from

Medicaid members for services NOT covered by Indiana Medicaid. To the best of our knowledge, counseling IS a covered service.

Updated 2/21/23

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Insurance

Some Insurances are accepted.

All Health Savings Accounts (HSA/Benny Cards) are accepted for therapy sessions inside the office.

For those who have an insurance not listed:

You may want to contact your insurance and inquire about your out-of-network benefits.

We are able to provide you with a bill that you can submit to your insurance company for reimbursement.

HSA cards can be used to pay for sessions out-of-network.

In Network Providers

Aetna

Anthem Blue Cross Blue Sheild

Blue Cross Blue Shield

Encore

IU Health

United Healthcare Student Resources with Purdue

Our Cancelation Policy is this:

Please provide 48 hours notice for cancelations.

This cancellation policy is in place because, we reserve a full hour for the session. If a client cancels with less than a full 48-hour notice, we won’t be able to fill that time slot from our cancelation list. We want you to know that our cancellation policy in not a penalty or a punishment. 99.9% of our clients understand this. Very rarely, will we have a client who will feel that he or she is being punished when we charge them a late cancellation fee. We want to make sure that you don’t feel this way, if someday you miss an appointment. Truth be told, if you are in counseling long enough, at some point you might forget about an appointment, or something will come up that will result in you missing an appointment.

We are never upset with clients when they miss or cancel an appointment. In return, our clients understand that scheduling an appointment with us is like buying tickets to an event. If you miss the event, it doesn’t matter why you missed it, or even if it was your first time, you can’t turn in your tickets for a refund. Our late cancellation and no-show fee is $75.

*It’s important to remember that insurance will not pay for missed appointments, so you will be responsible for the full $75.

Out Of Network Benefits

*Out Of Network Coverage:

We are happy to print you a CMS-1500 Form so that you can file with your provider for reimbursement, according to your policy.

HSA/FLEX/Benny Cards may be used to pay for all sessions for out of network services.

Telemental Health

Phone and video conference appointments are available to Indiana residents. Please request an appointment https://www.therapyportal.com/p/harmony47905/ and indicate in the “memo” field if you would like an in office or video conference appointment.

If you are considering hurting yourself or someone else, this service is not for you! Please go to an emergency room of a hospital, call 911, or contact the National Suicide Hotline (United States) at 1-800-SUICIDE or 1-800-273-TALK.

Additional phone numbers can be located at suicidepreventionlifeline.org